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International Survey Of Older Adults Finds Shortcomings In Access, Coordination, And Patient-Centered Care

November 20, 2014 Comments off

International Survey Of Older Adults Finds Shortcomings In Access, Coordination, And Patient-Centered Care
Source: Health Affairs

Industrialized nations face the common challenge of caring for aging populations, with rising rates of chronic disease and disability. Our 2014 computer-assisted telephone survey of the health and care experiences among 15,617 adults age sixty-five or older in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States has found that US older adults were sicker than their counterparts abroad. Out-of-pocket expenses posed greater problems in the United States than elsewhere. Accessing primary care and avoiding the emergency department tended to be more difficult in the United States, Canada, and Sweden than in other surveyed countries. One-fifth or more of older adults reported receiving uncoordinated care in all countries except France. US respondents were among the most likely to have discussed health-promoting behaviors with a clinician, to have a chronic care plan tailored to their daily life, and to have engaged in end-of-life care planning. Finally, in half of the countries, one-fifth or more of chronically ill adults were caregivers themselves.

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Estimated Burden of Keratitis — United States, 2010

November 17, 2014 Comments off

Estimated Burden of Keratitis — United States, 2010
Source: Morbidity and Mortality Weekly Report (CDC)

Keratitis, inflammation of the cornea, can result in partial or total loss of vision and can result from infectious agents (e.g., microbes including bacteria, fungi, amebae, and viruses) or from noninfectious causes (e.g., eye trauma, chemical exposure, and ultraviolet exposure). Contact lens wear is the major risk factor for microbial keratitis (1–3); outbreaks of Fusarium and Acanthamoeba keratitis have been associated with contact lens multipurpose solution use (4,5), and poor contact lens hygiene is a major risk factor for a spectrum of eye complications, including microbial keratitis and other contact lens–related inflammation (3,6,7). However, the overall burden and the epidemiology of keratitis in the United States have not been well described. To estimate the incidence and cost of keratitis, national ambulatory-care and emergency department databases were analyzed. The results of this analysis showed that an estimated 930,000 doctor’s office and outpatient clinic visits and 58,000 emergency department visits for keratitis or contact lens disorders occur annually; 76.5% of keratitis visits result in antimicrobial prescriptions. Episodes of keratitis and contact lens disorders cost an estimated $175 million in direct health care expenditures, including $58 million for Medicare patients and $12 million for Medicaid patients each year. Office and outpatient clinic visits occupied over 250,000 hours of clinician time annually. Developing effective prevention messages that are disseminated to contact lens users and investigation of additional preventive efforts are important measures to reduce the national incidence of microbial keratitis.

Reducing Tobacco Use and Secondhand Smoke Exposure: Comprehensive Tobacco Control Programs

November 17, 2014 Comments off

Reducing Tobacco Use and Secondhand Smoke Exposure: Comprehensive Tobacco Control Programs
Source: Community Preventive Services Task Force

The Community Preventive Services Task Force recommends comprehensive tobacco control programs based on strong evidence of effectiveness in reducing tobacco use and secondhand smoke exposure. Evidence indicates these programs reduce the prevalence of tobacco use among adults and young people, reduce tobacco product consumption, increase quitting, and contribute to reductions in tobacco-related diseases and deaths. Economic evidence indicates that comprehensive tobacco control programs are cost-effective, and savings from averted healthcare costs exceed intervention costs.

Read the full Task Force Finding and Rationale Statement for details including implementation issues, possible added benefits, potential harms, and evidence gaps.

Antimicrobial Resistance: A Problem Without Borders (2014)

November 13, 2014 Comments off

Antimicrobial Resistance: A Problem Without Borders (2014)
Source: Institute of Medicine

The Centers for Disease Control and Prevention identified antimicrobial resistance as one of five urgent health threats facing the United States this year. Antimicrobial resistance is a global health security threat that will demand collaboration from many stakeholders around the world. This report highlights the crosscutting character of antimicrobial resistance and the needs for many disciplines to be brought together to be able to deal with it more effectively.

CRS — Ozone Air Quality Standards: EPA’s 2015 Revision (October 3, 2014)

November 12, 2014 Comments off

Ozone Air Quality Standards: EPA’s 2015 Revision (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

The Environmental Protection Agency (EPA) is nearing the end of a statutorily required review of the National Ambient Air Quality Standards (NAAQS) for ground-level ozone. The agency is under a court order to propose any revisions to the standard by December 1, 2014.

NAAQS are standards for outdoor (ambient) air that are intended to protect public health and welfare from harmful concentrations of pollution. If the EPA Administrator changes the primary standard to a lower level, she would be concluding that protecting public health requires lower concentrations of ozone pollution than were previously judged to be safe. In high enough concentrations, ozone aggravates heart and lung diseases and may contribute to premature death. Ozone also can have negative effects on forests and crop yields, which the secondary (welfarebased) NAAQS is intended to protect.

As of July 2014, 123 million people (40% of the U.S. population) lived in areas classified “nonattainment” for the primary ozone NAAQS. A more stringent standard might affect more areas, and sources that contribute to nonattainment might have to adopt more stringent emission controls. This could be costly: in 2011, EPA concluded that the annual cost of emission controls necessary to attain a primary NAAQS of 0.070 ppm (as opposed to the then-current standard of 0.075 parts per million, which remains in place today) would be at least $11 billion in 2020.

See also: EPA’s Upcoming Ozone Standard: How Much Will Compliance Cost?, CRS Insights (October 15, 2014) (PDF)

New From the GAO

November 6, 2014 Comments off

New GAO Reports
Source: Government Accountability Office

1. Food Safety: FDA and USDA Should Strengthen Pesticide Residue Monitoring Programs and Further Disclose Monitoring Limitations. GAO-15-38, October 7.
http://www.gao.gov/products/GAO-15-38
Highlights – http://www.gao.gov/assets/670/666407.pdf

2. Fiscal Year 2014 Agreed-Upon Procedures: Excise Tax Distributions to the Airport and Airway Trust Fund and the Highway Trust Fund. GAO-15-152R, November 6.
http://www.gao.gov/products/GAO-15-152R

3. Information Sharing: DHS Is Assessing Fusion Center Capabilities and Results, but Needs to More Accurately Account for Federal Funding Provided to Centers. GAO-15-155, November 4.
http://www.gao.gov/products/GAO-15-155
Highlights – http://www.gao.gov/assets/670/666759.pdf

CRS — U.S. and International Health Responses to the Ebola Outbreak in West Africa (October 29, 2014)

November 6, 2014 Comments off

U.S. and International Health Responses to the Ebola Outbreak in West Africa (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

In March 2014, an Ebola Virus Disease (EVD) outbreak was reported in Guinea, West Africa. The outbreak is the first in West Africa and has caused an unprecedented number of cases and deaths. The outbreak is continuing to spread in Guinea, Sierra Leone, and Liberia (the “affected countries”); it has been contained in Nigeria and Senegal, and has been detected in Mali. As of October 22, 2014, more than 10,000 people have contracted EVD, more than half of whom have died.

In the aggregate, between 1976, when Ebola was first identified, through 2012, there were 2,387 cases, including 1,590 deaths, all in Central and East Africa. The number of Ebola cases in this outbreak is four times higher than the combined total of all prior outbreaks, and the number of cases is doubling monthly. The U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have projected an exponential increase in cases. WHO estimated that by the end of November, some 20,000 people may contract Ebola; CDC estimated that “without additional interventions or changes in community behavior,” up to 1.4 million could contract EVD in Liberia and Sierra Leone by January 2015. CDC indicates, however, that the outbreak may not reach such proportions since responses are intensifying. In Liberia, for example, improvements in burial practices have resulted in roughly 85% of all bodies being collected within 24 hours of being reported to national officials.

See also: Increased Department of Defense Role in U.S. Ebola Response – CRS Insights (October 10, 2014) (PDF; via U.S. State Department Foreign Press Center)

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