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Genworth 2013 Annual Cost of Care Survey: Nursing Home Costs Up, At Home Care Prices Remain Relatively Flat
Source: Genworth
In its 10th year, the Genworth 2013 Cost of Care Survey shows a continued upward trajectory when it comes to the cost of obtaining long term care services. The cost of receiving care in a setting such as an assisted living facility or nursing home is dramatically increasing, while the cost to receive care at home through homemaker services or a home health aide is rising at a much more gradual pace.
"There are many factors that go into rising care costs, from the number of available skilled professionals to real estate prices," said Pat Foley, president of distribution and marketing for Genworth. "If you look at national private nursing home costs over the past 10 years that we’ve done this study, the median annual costs have gone up from $65,200 to $83,950, increasing at more than four percent a year. The better news is that costs for homemaker services and home health aides have remained relatively flat. Since 70% of Genworth’s first time long term care claimants choose in-home care, these costs have remained more manageable[1]."
Nationally, the 2013 median hourly cost of homemaker services and home health aide services is $18 and $19 respectively. Homemaker costs have risen just 1.4 percent since 2012 and 0.8 annually over the past five years. Home health aide services have risen 2.3 percent since 2012 and 1.0 percent annually over the past five years.
The costs to receive care in an assisted living facility are rising much faster. The median annual cost for care in an assisted living facility is $41,400. This represents an increase of 4.6 percent since 2012 and a 4.3 percent annual increase over the past five years. The comparable cost for a private nursing home room rose 3.6 percent from 2012 to 2013, to $83,950, or 4.5 percent annualized over the past five years.
The effect of physicians’ body weight on patient attitudes: implications for physician selection, trust and ad herence to medical advice
Source: International Journal of Obesity
Background:
Research has documented negative stigma by health providers toward overweight and obese patients, but it is unknown whether physicians themselves are vulnerable to weight bias from patients.
Purpose:
This study assessed public perceptions of normal weight, overweight or obese physicians to identify how physicians’ body weight affects patients’ selection, trust and willingness to follow the medical advice of providers.
Methods:
An online sample of 358 adults were randomly assigned to one of three survey conditions in which they completed a questionnaire assessing their perceptions of physicians who were described as normal weight, overweight or obese. Participants also completed a measure of explicit weight bias (Fat Phobia Scale) to determine whether antifat attitudes are associated with weight-related perceptions of physicians.
Results:
Respondents reported more mistrust of physicians who are overweight or obese, were less inclined to follow their medical advice, and were more likely to change providers if the physician was perceived to be overweight or obese, compared to normal-weight physicians who elicited significantly more favorable reactions. These weight biases remained present regardless of participants’ own body weight. Inspection of interaction effects revealed opposing effects of weight bias between the obese/overweight and normal-weight physician conditions. Stronger weight bias led to higher trust, more compassion, more inclination to follow advice, and less inclination to change doctors when the physician was presented as normal weight. In contrast, stronger weight bias led to less trust, less compassion, less inclination to follow advice and higher inclination to change doctors when the physician was presented as obese.
Conclusions:
This study suggests that providers perceived to be overweight or obese may be vulnerable to biased attitudes from patients, and that providers’ excess weight may negatively affect patients’ perceptions of their credibility, level of trust and inclination to follow medical advice.
Medicare Hospice: Use of General Inpatient Care
Medicare Hospice: Use of General Inpatient Care
Source: U.S. Department of Health and Human Services, Office of Inspector General
WHY WE DID THIS STUDY
Hospice general inpatient care (GIP) is for pain control or symptom management provided in an inpatient facility that cannot be managed in other settings. The care is intended to be short-term and is the second most expensive level of hospice care. GIP may be provided in one of three settings: a Medicare-certified hospice inpatient unit, a hospital, or a skilled nursing facility (SNF). CMS staff have expressed concerns about possible misuse of GIP, such as care being billed for but not provided, long lengths of stay, and beneficiaries receiving care unnecessarily.
HOW WE DID THIS STUDY
We based this memorandum report on an analysis of Medicare Part A hospice claims. We analyzed the claims data to identify the hospice beneficiaries who received GIP during 2011, the number of days that each beneficiary received this care, and the setting in which the care was provided. We also determined from the claims data the terminal illness of each beneficiary. In addition, we identified all of the Medicare-certified hospices that provided hospice care in 2011.
WHAT WE FOUND
We found that Medicare paid $1.1 billion for GIP in 2011, most of which was provided in hospice inpatient units, as opposed to hospitals or SNFs. Twenty-three percent of Medicare hospice beneficiaries received GIP during the year. One-third of beneficiaries’ GIP stays exceeded 5 days, with 11 percent lasting 10 days or more. The hospices that used inpatient units provided GIP to more of their beneficiaries and for longer periods of time than hospices that used other settings. We also found that 953 hospices, or 27 percent of Medicare hospices, did not provide any GIP to Medicare beneficiaries in 2011 and that 429 of these hospices did not provide any level of hospice care other than routine home care.
These results raise several questions about GIP. Long lengths of stay and the use of GIP in inpatient units need further review to ensure that hospices are using GIP as intended and providing the appropriate level of care. Also, CMS should focus on hospices that do not provide GIP and ensure that these hospices are providing beneficiaries access to needed levels of care at the end of their lives. One option is for CMS to adopt a quality measure regarding hospices’ ability to provide all hospice services.
Placebo Use in the United Kingdom: Results from a National Survey of Primary Care Practitioners
Placebo Use in the United Kingdom: Results from a National Survey of Primary Care Practitioners
Source: PLoS ONE
Objectives
Surveys in various countries suggest 17% to 80% of doctors prescribe ‘placebos’ in routine practice, but prevalence of placebo use in UK primary care is unknown.
Methods
We administered a web-based questionnaire to a representative sample of UK general practitioners. Following surveys conducted in other countries we divided placebos into ‘pure’ and ‘impure’. ‘Impure’ placebos are interventions with clear efficacy for certain conditions but are prescribed for ailments where their efficacy is unknown, such as antibiotics for suspected viral infections. ‘Pure’ placebos are interventions such as sugar pills or saline injections without direct pharmacologically active ingredients for the condition being treated. We initiated the survey in April 2012. Two reminders were sent and electronic data collection closed after 4 weeks.
Results
We surveyed 1715 general practitioners and 783 (46%) completed our questionnaire. Our respondents were similar to those of all registered UK doctors suggesting our results are generalizable. 12% (95% CI 10 to 15) of respondents used pure placebos while 97% (95% CI 96 to 98) used impure placebos at least once in their career. 1% of respondents used pure placebos, and 77% (95% CI 74 to 79) used impure placebos at least once per week. Most (66% for pure, 84% for impure) respondents stated placebos were ethical in some circumstances.
Conclusion and implications
Placebo use is common in primary care but questions remain about their benefits, harms, costs, and whether they can be delivered ethically. Further research is required to investigate ethically acceptable and cost-effective placebo interventions.
See: 97 Percent of UK Doctors Have Given Placebos to Patients at Least Once (Science Daily)
Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices
Source: Agency for Healthcare Research and Quality
Objectives. To review important patient safety practices for evidence of effectiveness, implementation, and adoption.
Data sources. Searches of multiple computerized databases, gray literature, and the judgments of a 20-member panel of patient safety stakeholders.
Review methods. The judgments of the stakeholders were used to prioritize patient safety practices for review, and to select which practices received in-depth reviews and which received brief reviews. In-depth reviews consisted of a formal literature search, usually of multiple databases, and included gray literature, where applicable. In-depth reviews assessed practices on the following domains:
• How important is the problem?
• What is the patient safety practice?
• Why should this practice work?
• What are the beneficial effects of the practice?
• What are the harms of the practice?
• How has the practice been implemented, and in what contexts?
• Are there any data about costs?
• Are there data about the effect of context on effectiveness?
We assessed individual studies for risk of bias using tools appropriate to specific study designs. We assessed the strength of evidence of effectiveness using a system developed for this project. Brief reviews had focused literature searches for focused questions. All practices were then summarized on the following domains: scope of the problem, strength of evidence for effectiveness, evidence on potential for harmful unintended consequences, estimate of costs, how much is known about implementation and how difficult the practice is to implement. Stakeholder judgment was then used to identify practices that were “strongly encouraged” for adoption, and those practices that were “encouraged” for adoption.
Results. From an initial list of over 100 patient safety practices, the stakeholders identified 41 practices as a priority for this review: 18 in-depth reviews and 23 brief reviews. Of these, 20 practices had their strength of evidence of effectiveness rated as at least “moderate,” and 25 practices had at least “moderate” evidence of how to implement them. Ten practices were classified by the stakeholders as having sufficient evidence of effectiveness and implementation and should be “strongly encouraged” for adoption, and an additional 12 practices were classified as those that should be “encouraged” for adoption.
Conclusions. The evidence supporting the effectiveness of many patient safety practices has improved substantially over the past decade. Evidence about implementation and context has also improved, but continues to lag behind evidence of effectiveness. Twenty-two patient safety practices are sufficiently well understood, and health care providers can consider adopting them now.
Protecting Patient Privacy and Data Security
Protecting Patient Privacy and Data Security
Source: New England Journal of Medicine
On December 4, 2012, two Australian radio DJs called London’s King Edward VII’s Hospital, identified themselves, in fake British accents, as Queen Elizabeth and Prince Charles, and asked about a celebrity patient who had been admitted for pregnancy complications. A nurse, filling in at the reception desk in the early morning hours, answered the phone and, without attempting to verify the callers’ identities, transferred them to the duty nurse caring for the Duchess of Cambridge. The duty nurse then provided them with confidential patient information.1 The Australian DJs broadcast the phone call, considering it a humorous prank, but as the world knows, it had disastrous consequences.
How confident are U.S. hospitals, nursing homes, and physicians’ offices that their staff would appropriately deny patient information to an unknown caller?
Leading Medical Specialty Societies Identify 90 Tests and Treatments to Question
Leading Medical Specialty Societies Identify 90 Tests and Treatments to Question
Source: American Board of Internal Medicine
Seventeen leading medical specialty societies have identified specific tests, procedures or medication therapies they say are commonly ordered, but which are not always necessary—and could cause undue harm. To date, more than 130 tests and procedures to question have been released as part of the ABIM Foundation’s Choosing Wisely® campaign, which aims to spark conversations between patients and physicians about what care is really necessary.
Each specialty society participating in Choosing Wisely identified five specific tests or procedures that are commonly done in their profession, but whose use should be questioned. In April 2012, nine medical specialty societies each released Choosing Wisely lists.
UK — Infection prevention and control in care homes: information resource published
Infection prevention and control in care homes: information resource published
Source: Department of Health (UK)
An information resource and summary for care workers on the prevention and control of infection in care homes has been published.
These aim to assist staff in taking all reasonable steps to protect residents and staff from acquiring infections and cross infection; and provide information and guidance on infection prevention and control that will assist managers undertaking risk assessments and in developing policies.
The steps taken in care homes to protect residents and staff from infection represent an important element in the quality of care. Therefore families and carers want to be assured that the care their relatives and dependants receive is provided in a clean and safe environment.
Infections acquired in care homes may be serious and, in some cases, life-threatening. These may worsen underlying medical conditions and adversely affect recovery. Infections may be caused by organisms resistant to antibiotics and the high media profile they generate may alarm residents, their relatives and carers.
How to Avoid Being Readmitted to the Hospital
How to Avoid Being Readmitted to the Hospital
Source: Robert Wood Johnson Foundation
Leaving the hospital sounds simple. But all too often, people find themselves back at the hospital within only a few weeks. With better planning and better communication, many of these return visits can be avoided. This fact sheet from Care About Your Care can help patients take steps to avoid being readmitted.
- Ask and ask again
- Say it back
- Have a discharge plan
- Manage your medications
- Keep appointments
- Know what to do if you don’t feel well
See also:
Care About Your Care Discharge Checklist & Care Transition Plan
Ten Things You Should Know About Care Transitions
Reducing Avoidable Readmissions Through Better Care Transitions
Hospice Care in America 2012
Hospice Care in America 2012 (PDF)
Source: National Hospice and Palliative Care Organization
NHPCO Facts and Figures: Hospice Care in America provides an annual overview of important trends in the growth, delivery and quality of hospice care across the country . This overview provides specific information on:
- Hospice patient characteristics (e .g ., gender, age, ethnicity, race, primary diagnosis, and length of service)
- Hospice provider characteristics (e .g ., total patients served, organizational type, size, and tax status)
- Location and level of care
- Role of paid and volunteer staff
General Practitioners’ Choices and Their Determinants When Starting Treatment for Major Depression: A Cross Sectional, Randomized Case-Vignette Survey
General Practitioners’ Choices and Their Determinants When Starting Treatment for Major Depression: A Cross Sectional, Randomized Case-Vignette Survey
Source: PLoS ONE
Background
In developed countries, primary care physicians manage most patients with depression. Relatively few studies allow a comprehensive assessment of the decisions these doctors make in these cases and the factors associated with these decisions. We studied how general practitioners (GPs) manage the acute phase of a new episode of non-comorbid major depression (MD) and the factors associated with their decisions.Methodology/Principal Findings
In this cross-sectional telephone survey, professional investigators interviewed an existing panel of randomly selected GPs (1249/1431, response rate: 87.3%). We used case-vignettes about new MD episodes in 8 versions differing by patient gender and socioeconomic status (blue/white collar) and disease intensity (mild/severe). GPs were randomized to receive one of these 8 versions. Overall, 82.6% chose pharmacotherapy; among them GPs chose either an antidepressant (79.8%) or an anxiolytic/hypnotic alone (18.5%). They rarely recommended referral for psychotherapy alone, regardless of severity, but 38.2% chose it in combination with pharmacotherapy. Antidepressant prescription was associated with severity of depression (OR = 1.74; 95%CI = 1.33–2.27), patient gender (female, OR = 0.75; 95%CI = 0.58–0.98), GP personal characteristics (e.g. history of antidepressant treatment: OR = 2.31; 95%CI = 1.41–3.81) and GP belief that antidepressants are overprescribed in France (OR = 0.63; 95%CI = 0.48–0.82). The combination of antidepressants and psychotherapy was associated with severity of depression (OR = 1.82; 95%CI = 1.31–2.52), patient’s white-collar status (OR = 1.58; 95%CI = 1.14–2.18), and GPs’ dissatisfaction with cooperation with mental health specialists (OR = 0.63; 95%CI = 0.45–0.89). These choices were not associated with either GPs’ professional characteristics or psychiatrist density in the GP’s practice areas.Conclusions/Significance
GPs’ choices for treating severe MD complied with clinical guidelines better than those for mild MD; GPs rarely recommended psychotherapy alone but rather as a complement to pharmacotherapy. Their decisions were mainly influenced by personal life experience and attitudes regarding treatment more than by professional characteristics. These results call into question the methods and content of continuing medical education in France about MD management.
CRS — Emergency Response: Civil Liability of Volunteer Health Professionals
Emergency Response: Civil Liability of Volunteer Health Professionals (PDF)
Source: Congressional Research Service (via University of North Texas Digital Library)
The devastation inflicted on the Gulf region by Hurricanes Katrina and Rita in 2005 and Hurricanes Gustav and Ike in 2008, in addition to recent disasters in the Midwest due to tornadoes and flooding, triggered mass relief efforts by local, state, and federal government agencies, as well as private organizations and individuals. As unpaid volunteers have carried out much of the relief effort, some have questioned whether such volunteers—particularly medical personnel, so-called “volunteer health professionals” (VHPs)—will be protected from potential civil liability in carrying out their duties. This report provides a general overview of the various federal and state liability protections available to VHPs responding to disasters. This report does not discuss liability of VHPs who go abroad to render assistance.
The absence of cruelty is not the presence of humanness: physicians and the death penalty in the United States
Source: Philosophy, Ethics, and Humanities in Medicine
The death penalty by lethal injection is a legal punishment in the United States. Sodium Thiopental, once used in the death penalty cocktail, is no longer available for use in the United States as a consequence of this association. Anesthesiologists possess knowledge of Sodium Thiopental and possible chemical alternatives. Further, lethal injection has the look and feel of a medical act thereby encouraging physician participation and comment. Concern has been raised that the death penalty by lethal injection, is cruel. Physicians are ethically directed to prevent cruelty within the doctor-patient relationship and ethically prohibited from participation in any component of the death penalty. The US Supreme Court ruled that the death penalty is not cruel per se and is not in conflict with the 8th amendment of the US constitution. If the death penalty is not cruel, it requires no further refinement. If, on the other hand, the death penalty is in fact cruel, physicians have no mandate outside of the doctor patient relationship to reduce cruelty. Any intervention in the name of cruelty reduction, in the setting of lethal injection, does not lead to a more humane form of punishment. If physicians contend that the death penalty can be botched, they wrongly direct that it can be improved. The death penalty cocktail, as a method to reduce suffering during execution, is an unverifiable claim. At best, anesthetics produce an outward appearance of calmness only and do not address suffering as a consequence of the anticipation of death on the part of the condemned.
Flattening the Trajectory of Health Care Spending: Foster Efficient and Accountable Providers
Flattening the Trajectory of Health Care Spending: Foster Efficient and Accountable Providers
Source: RAND Corporation
Key Findings
- Providers drive health care spending through the guidance they provide to patients about needed diagnostic tests, treatments, hospitalizations, and referrals, as well as through their own fees.
- Providers can dramatically improve American health care by focusing on "value" instead of "volume," eliminating wasteful and inappropriate care, applying the best available evidence to their practices, and enhancing patient safety.
- Strengthening primary care promises to be a good investment, but the existing pipeline for primary care physicians is insufficient to meet future demand.
Inappropriate Payments to Skilled Nursing Facilities Cost Medicare More Than a Billion Dollars in 2009
Inappropriate Payments to Skilled Nursing Facilities Cost Medicare More Than a Billion Dollars in 2009
Source: U.S. Department of Health and Human Services, Office of Inspector General
Summary
WHY WE DID THIS STUDY
In recent years, the Office of Inspector General has identified a number of problems with billing by skilled nursing facilities (SNF), including the submission of inaccurate, medically unnecessary, and fraudulent claims. Further, the Medicare Payment Advisory Commission has raised concerns about SNFs’ improperly billing for therapy to obtain additional Medicare payments. In fiscal year (FY) 2012, Medicare paid $32.2 billion for SNF services.
HOW WE DID THIS STUDY
We based this study on a medical record review of a stratified random sample of SNF claims from 2009. The reviewers determined whether the information reported by the SNFs on the Minimum Data Set (MDS) was supported by and consistent with the medical record. The MDS is a standardized tool that SNFs use to assess each beneficiary. SNFs use the information on the MDS to classify beneficiaries into resource utilization groups (RUG). The RUGs determine how much Medicare pays the SNFs.
WHAT WE FOUND
SNFs billed one-quarter of all claims in error in 2009, resulting in $1.5 billion in inappropriate Medicare payments. The majority of the claims in error were upcoded; many of these claims were for ultrahigh therapy. The remaining claims in error were downcoded or did not meet Medicare coverage requirements. In addition, SNFs misreported information on the MDS for 47 percent of claims. SNFs commonly misreported therapy, which largely determines the RUG and the amount that Medicare pays the SNF.
WHAT WE RECOMMEND
We recognize that CMS has recently made several significant changes to SNF payments. However, more needs to be done to reduce inappropriate payments to SNFs. We recommend that CMS: (1) increase and expand reviews of SNF claims, (2) use its Fraud Prevention System to identify SNFs that are billing for higher paying RUGs, (3) monitor compliance with new therapy assessments, (4) change the current method for determining how much therapy is needed to ensure appropriate payments, (5) improve the accuracy of MDS items, and (6) follow up on the SNFs that billed in error. CMS concurred with all six recommendations.
Implicit and Explicit Anti-Fat Bias among a Large Sample of Medical Doctors by BMI, Race/Ethnicity and Gender
Source: PLoS ONE
Overweight patients report weight discrimination in health care settings and subsequent avoidance of routine preventive health care. The purpose of this study was to examine implicit and explicit attitudes about weight among a large group of medical doctors (MDs) to determine the pervasiveness of negative attitudes about weight among MDs. Test-takers voluntarily accessed a public Web site, known as Project Implicit®, and opted to complete the Weight Implicit Association Test (IAT) (N = 359,261). A sub-sample identified their highest level of education as MD (N = 2,284). Among the MDs, 55% were female, 78% reported their race as white, and 62% had a normal range BMI. This large sample of test-takers showed strong implicit anti-fat bias (Cohen’s d = 1.0). MDs, on average, also showed strong implicit anti-fat bias (Cohen’s d = 0.93). All test-takers and the MD sub-sample reported a strong preference for thin people rather than fat people or a strong explicit anti-fat bias. We conclude that strong implicit and explicit anti-fat bias is as pervasive among MDs as it is among the general public. An important area for future research is to investigate the association between providers’ implicit and explicit attitudes about weight, patient reports of weight discrimination in health care, and quality of care delivered to overweight patients.
See: Anti-fat bias may be equally prevalent in general public and medical community (EurekAlert!)
Criminal Convictions for Nurse Aides With Substantiated Findings of Abuse, Neglect, and Misappropriation
Source: U.S. Department of Health and Human Services, Office of Inspector General
WHY WE DID THIS STUDY
The Patient Protection and Affordable Care Act mandates that OIG submit a report to Congress evaluating the Nationwide Program for National and State Background Checks on Direct Patient Access Employees of Long Term-Care Facilities and Providers not later than 180 days after the program’s completion. This memorandum report provides baseline information for the mandated report on the extent to which nurse aides with substantiated findings of abuse, neglect, and/or misappropriation had previous criminal convictions that could have been detected through background checks and the nature of those convictions.
HOW WE DID THIS STUDY
In September 2011, we requested from each State’s nurse aide registry a roster of all nurse aides who received a substantiated finding of abuse, neglect, and/or misappropriation of property during 2010. For each nurse aide on these rosters, we requested criminal history record information from the Federal Bureau of Investigation. We recorded convictions from each positively matched individual’s criminal history.
WHAT WE FOUND
Nineteen percent of nurse aides with substantiated findings had at least one conviction in their criminal history records prior to their substantiated finding. Among these nurse aides, the most common conviction (53 percent) was for crimes against property (e.g., burglary, shoplifting, and writing bad checks). We also determined whether nurse aides with each type of substantiated finding were more likely to have certain types of convictions. We found that nurse aides with substantiated findings of either abuse or neglect were 3.2 times more likely to have a conviction of crime against persons than nurse aides with substantiated findings of misappropriation, and nurse aides with substantiated findings of misappropriation were 1.6 times more likely to have a conviction of crime against property than nurse aides with substantiated findings of abuse or neglect.
WHAT WE CONCLUDED
CMS may wish to provide the information in this memorandum report to States that participate in the background check program as well as to the Long Term Care Criminal Convictions Workgroup. We plan to use this baseline information in the mandated report to assess the extent to which the background check program may reduce the number of incidents of neglect, abuse, and misappropriation of resident property.
Excluded Individuals Employed by Providers Enrolled in Medicaid Managed Care Entities
Excluded Individuals Employed by Providers Enrolled in Medicaid Managed Care Entities (PDF)
Source: U.S. Department of Health and Human Services, Office of Inspector General
WHY WE DID THIS STUDY
OIG is authorized to exclude certain individuals and entities (providers) from participating in federally funded health care programs, such as Medicaid managed care. These programs are generally prohibited from paying for any items or services furnished, ordered, or prescribed by an excluded provider or paying anyone who contracts with an excluded provider. In Medicaid managed care, States contract with managed care entities (MCE) to provide healthcare services to enrolled beneficiaries. The managed care entities create and manage networks of providers who deliver healthcare services to the enrolled beneficiaries. Since the providers in the Medicaid managed care networks are not under direct oversight by the States, we wanted to determine if the provider networks are vulnerable to excluded providers.
HOW WE DID THIS STUDY
This is the second of two evaluations related to excluded providers in Medicaid managed care. In the prior study, entitled Excluded Providers in Medicaid Managed Care Entities (OEI‑07‑09‑00630), we compared the provider networks of 12 selected MCEs to the List of Excluded Individuals and Entities (LEIE) to identify excluded providers. In the current study, we selected a stratified random sample of 500 hospitals, nursing facilities, home health agencies, and pharmacies from the population of providers enrolled in the 12 MCEs. From each of the 500 sampled providers, we collected rosters of employees in 2011, and responses to a survey on the safeguards they used to ensure that excluded individuals are not employed. We compared the employee rosters to the LEIE to identify excluded individuals.
WHAT WE FOUND
Of the 248,869 individuals listed on the employee rosters requested from sampled providers, we identified 16 individuals who were excluded among the employees of 14 sampled providers. Incorrect names and failure of contractors to follow procedures contributed to the employment of the excluded individuals. Most providers reported using a variety of safeguards to ensure they do not employ excluded individuals, but identified costs and resource burdens as challenges in executing those safeguards. Seven percent of providers in the 12 selected MCEs do not check the exclusions status of their employees; most of these providers lacked knowledge regarding exclusions.
This report does not contain recommendations.
Influenza Vaccination Coverage Among Health-Care Personnel — 2011–12 Influenza Season, United States
Influenza Vaccination Coverage Among Health-Care Personnel — 2011–12 Influenza Season, United States
Source: Morbidity and Mortality Weekly Report (CDC)
Influenza vaccination of health-care personnel (HCP) is recommended by the Advisory Committee on Immunization Practices (ACIP) (1). Vaccination of HCP can reduce morbidity and mortality from influenza and its potentially serious consequences among HCP, their family members, and their patients (1–3). To provide timely estimates of influenza vaccination coverage and related data among HCP for the 2011–12 influenza season, CDC conducted an Internet panel survey with 2,348 HCP during April 2–20, 2012. This report summarizes the results of that survey, which found that, overall, 66.9% of HCP reported having had an influenza vaccination for the 2011–12 season. By occupation, vaccination coverage was 85.6% among physicians, 77.9% among nurses, and 62.8% among all other HCP participating in the survey. Vaccination coverage was 76.9% among HCP working in hospitals, 67.7% among those in physician offices, and 52.4% among those in long-term care facilities (LTCFs). Among HCP working in hospitals that required influenza vaccination, coverage was 95.2%; among HCP in hospitals not requiring vaccination, coverage was 68.2%. Widespread implementation of comprehensive HCP influenza vaccination strategies is needed, particularly among those who are not physicians or nurses and who work in LTCFs, to increase HCP vaccination coverage and minimize the risk for medical-care–acquired influenza illnesses.
See also: Influenza Vaccination Coverage Among Pregnant Women — 2011–12 Influenza Season, United States
When Patients Don’t Take Their Medicine: What Role Do Doctors Play in Promoting Prescription Adherence?
When Patients Don’t Take Their Medicine: What Role Do Doctors Play in Promoting Prescription Adherence?
Source: RAND Corporation
Analyses indicated that although physicians uniformly felt responsible for assessing and promoting adherence to prescriptions, only a minority of them asked detailed questions about adherence.
