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Progress With Electronic Health Record Adoption Among Emergency and Outpatient Departments: United States, 2006–2011

April 18, 2015 Comments off

Progress With Electronic Health Record Adoption Among Emergency and Outpatient Departments: United States, 2006–2011
Source: National Center for Health Statistics

Key findings

Data from the 2006–2011 National Hospital Ambulatory Medical Care Survey

  • In 2011, 84% of hospital emergency departments (EDs) used an electronic health record (EHR) system.
  • Adoption of a basic EHR system with a specific set of functionalities by EDs increased from 19% in 2007 to 54% in 2011.
  • In 2011, 73% of hospital outpatient departments (OPDs) used an EHR system, up from 29% in 2006.
  • Adoption of a basic EHR system with a specific set of functionalities by OPDs increased from 9% in 2007 to 57% in 2011.
  • From 2007 through 2011, adoption of Stage 1 Meaningful Use objectives by EDs and OPDs increased.In 2011, 14% of EDs and 16% of OPDs had EHR technology able to support nine Stage 1 Meaningful Use objectives.

Trends in Long-acting Reversible Contraception Use Among U.S. Women Aged 15–44

April 17, 2015 Comments off

Trends in Long-acting Reversible Contraception Use Among U.S. Women Aged 15–44
Source: National Center for Health Statistics

Key findings

Data from the National Survey of Family Growth

  • Use of long-acting reversible contraceptives (LARCs) declined between 1982 and 1988, remained stable through 2002, and then increased nearly five-fold in the last decade among women aged 15–44, from 1.5% in 2002 to 7.2% in 2011–2013.
  • The percentage of women using LARCs has remained highest among women aged 25–34, with more than twice as many women aged 25–34 (11.1%) using LARCs in 2011–2013 compared with women aged 15–24 (5.0%) and aged 35–44 (5.3%).
  • After decreasing between 1982 and 1988 and remaining stable from 1988 through 1995, LARC-use patterns diverged among Hispanic, non-Hispanic white, and non-Hispanic black women.
  • Women who have had at least one birth use LARCs at a higher rate compared with women who have had no previous births, and this difference has increased over time.

Problems Paying Medical Bills: Early Release of Estimates From the National Health Interview Survey, January 2011-June 2014

April 16, 2015 Comments off

Problems Paying Medical Bills: Early Release of Estimates From the National Health Interview Survey, January 2011-June 2014 (PDF)
Source: National Center for Health Statistics

  • The percentage of persons under age 65 who were in families having problems paying medical bills decreased from 21.3% (56.5 million) in 2011 to 17.8% (47.7 million) in the first 6 months of 2014.
  • Within each year, from 2011 through June 2014, children aged 0– 17 years were more likely than adults aged 18 – 64 to be in families having problems paying medical bills.
  • The percentage of children aged 0– 17 years who were in families having problems paying medical bills decreased from 23. 2 % in 2011 to 19.0 % in the first 6 months of 201 4.
  • In the first 6 months of 2014 , among persons under age 65, 31.2% of those who were uninsured, 24.2% of those who had public coverage, and 12.4% of those who had private coverage were in families having problems paying medical bills in the past 12 months.
  • In the first 6 months of 201 4 , 27.1% of poor, 28.0 % of near poor , and 12.6 % of not poor persons under age 65 were in families having problems paying medical bills in the past 12 months.

Emergency Department Visits for Drug Poisoning: United States, 2008–2011

April 14, 2015 Comments off

Emergency Department Visits for Drug Poisoning: United States, 2008–2011
Source: Centers for Disease Control and Prevention

Key findings
Data from the National Hospital Ambulatory Medical Care Survey, 2008–2011

  • During 2008–2011, an average of 1.1 million emergency department (ED) visits were made each year for drug poisoning, with a visit rate of 35.4 per 10,000 persons.
  • The ED visit rate for drug poisoning was highest among persons aged 20–34. The rate declined with age after 20–34, and rates for those aged 0–19 were similar to those aged 50 and over.
  • Drug-poisoning ED visit rates did not differ by sex and age, with the exception of persons aged 35–49, where females had a higher visit rate than males. The ED visit rate for unintentional drug poisoning was higher than self-inflicted drug poisoning overall and for males, but did not differ for females.
  • About one-quarter (24.5%) of drug-poisoning ED visits resulted in hospital admission.

Progress in Identifying Infants with Hearing Loss — United States, 2006–2012

April 10, 2015 Comments off

Progress in Identifying Infants with Hearing Loss — United States, 2006–2012
Source: Morbidity and Mortality Weekly Report (CDC)

Congenital hearing loss affects one to three of every 1,000 live born infants (1) and negatively impacts children through delayed speech, language, social, and emotional development when undetected (2,3). To address this public health issue, jurisdiction-based Early Hearing Detection and Intervention (EHDI) programs are working to ensure all newborns are screened for hearing loss, receive follow-up diagnostic testing (DX) if they do not pass the screening, and are enrolled in early intervention (EI) services if diagnosed with a permanent hearing loss. Although substantial progress has been made in the provision and documentation of services, challenges remain because, unlike screening results, diagnostic test results and enrollment in EI are not consistently reported to the EHDI programs. Therefore, it is difficult for states and territories to know if infants received recommended follow-up services (diagnostic testing and/or EI services), often resulting in infants being classified at either stage as lost to follow-up (LFU)/lost to documentation (LTD). To assess progress toward identifying children with hearing loss and reducing LFU/LTD for DX (LFU/LTD-DX) and EI enrollment (LFU/LTD-EI*), CDC analyzed EHDI surveillance data for 2006–2012. Results indicated that the number of jurisdictions reporting data increased from 49 to 57, rates of screening increased from 95.2% to 96.6%, rates of referral from screening decreased from 2.3% to 1.6%, rates of diagnosis among infants not passing their final screening increased from 4.8% to 10.3%, and enrollment in EI among children diagnosed with hearing loss increased from 55.4% to 61.7%, whereas rates for both LFU/LTD-DX and LFU/LTD-EI declined. These findings show sustained progress toward screening, identification, and enrollment in EI as well as highlighting the need for continued improvements in the provision and documentation of EHDI services.

CDC Grand Rounds: the Future of Cancer Screening

April 7, 2015 Comments off

CDC Grand Rounds: the Future of Cancer Screening
Source: Morbidity and Mortality Weekly Report (CDC)

Cancer is the second leading cause of death in the United States, with 52% of deaths caused by cancers of the lung and bronchus, female breast, uterine cervix, colon and rectum, oral cavity and pharynx, prostate, and skin (melanoma) (1). In the 1930s, uterine cancer, including cancer of the uterine cervix, was the leading cause of cancer deaths among women in the United States (2). With the advent of the Papanicolaou (Pap) test in the 1950s to detect cellular level changes in the cervix, cervical cancer death rates declined significantly (2). Since this first cancer screening test, others have been developed that detect the presence of cancer through imaging procedures (e.g., mammography, endoscopy, and computed tomography) and laboratory tests (e.g., fecal occult blood tests) (3).

The U.S. Preventive Services Task Force (USPSTF) provides cancer screening recommendations and continually reviews the scientific evidence for the potential benefits and harms of screening (4). USPSTF cancer screening recommendations that are graded A or B (indicating that they are recommended by USPSTF) include those for breast cancer, cervical cancer, colorectal cancer, and for lung cancer in heavy smokers (4) (Table 1); Grade A indicates high certainty that the net benefit is substantial, and Grade B indicates high certainty that the net benefit is moderate, or moderate certainty exists that the net benefit is moderate to substantial. Healthy People 2020 objectives include cancer-related objectives that address incidence, mortality, and screening for each of these cancers; no objective has been established for lung cancer screening because it was not recommended by USPSTF until 2013, after the Healthy People 2020 objectives were released (5) (Table 2).

Driving Among High School Students — United States, 2013

April 6, 2015 Comments off

Driving Among High School Students — United States, 2013
Source: Morbidity and Mortality Weekly Report (CDC)

During 2004–2013, the number of passenger vehicle drivers aged 16–19 years involved in fatal crashes in the United States declined by 55% from 5,724 to 2,568.* In addition to graduated driver licensing (GDL) programs (1) and safer vehicles,† other possible contributors to the decline include adolescents waiting longer to get their driver licenses and driving less (2). The crash risk for drivers of any age is highest during the first months of independent driving, and this risk is highest for the youngest teenage drivers (3). To estimate the percentage of high school students aged ≥16 years who have driven during the past 30 days, by age, race/ethnicity, and location, CDC analyzed 2013 data from the national Youth Risk Behavior Survey (YRBS) and YRBS data collected by 42 states and 21 large urban school districts. Nationwide, 76.3% of high school students aged ≥16 years reported having driven during the 30 days before the survey; 83.2% of white students had driven compared with <70% of black and Hispanic students. Across 42 states, the percentage of students who drove ranged from 53.8% to 90.2%. Driving prevalence was higher in the midwestern and mountain states. Across the 21 large urban school districts, the percentage of drivers varied more than twofold from 30.2% to 76.0%. This report provides the most detailed evidence to date that the percentage of students who drive varies substantially depending on where they live. Such information will be vital as states and communities consider potential ways to improve safety for older teenage novice drivers and plan for safe, affordable transportation options for those who do not drive.

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