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September 2013 Briefing - Critical Care

September 2013 Briefing - Critical Care

Here are what the editors at HealthDay consider to be the most important developments in Critical Care for September 2013. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Lower National Health Spending Due to Slow Economy

MONDAY, Sept. 30 (HealthDay News) -- National health care expenditures remain sluggish but are expected to grow at a rate of approximately 6.2 percent per year after 2014, with federal, state, and local governments accounting for half, according to research published online Sept. 18 in Health Affairs.

Abstract (http://content.healthaffairs.org/content/early/2013/09/13/hlthaff.2013.0721 )Full Text (subscription or payment may be required) (http://content.healthaffairs.org/content/early/2013/09/13/hlthaff.2013.0721.full.pdf+html )

Medicare, Medicaid Will Still Run If Government Shuts Down

MONDAY, Sept. 30 (HealthDay News) -- According to U.S. officials, veterans and Medicare and Medicaid recipients will continue to receive health care benefits even if the federal government shuts down on Tuesday.

More Information (http://www.hhs.gov/ )

Only One-Third of Voters Think Congress Should Delay ACA

MONDAY, Sept. 30 (HealthDay News) -- With a government shutdown impending, only one-third of voters think that Congress should delay, defund, or repeal the health care laws set to take effect imminently, according to a report from The Morning Consult.

More Information (http://themorningconsult.com/topline-results-september-2013-tracking-poll/ )

Mobile Devices Can Facilitate Universal Vital Sign Monitoring

MONDAY, Sept. 30 (HealthDay News) -- Mobile devices are well suited to provide universal access to the monitoring of vital signs, according to a review published in the October issue of Anesthesia & Analgesia.

Abstract (http://www.anesthesia-analgesia.org/content/117/4/883.abstract )Full Text (subscription or payment may be required) (http://www.anesthesia-analgesia.org/content/117/4/883.long )

DOL Clarifies Employer Health Insurance Notification Duty

MONDAY, Sept. 30 (HealthDay News) -- The U.S. Department of Labor has provided clarification in the form of a frequently-asked-questions (FAQ) document, relating to employer obligations to provide employees with written notice about the Affordable Care Act's health insurance marketplaces by Oct. 1, 2013.

More Information (http://www.dol.gov/ebsa/faqs/faq-noticeofcoverageoptions.html )

Practical Tips Offered for Medical Employee Satisfaction

FRIDAY, Sept. 27 (HealthDay News) -- Managing staff is a learned skill, and one for which physicians are often ill-equipped. An article published Sept. 25 in Medical Economics lays out some practical tips and advice for motivating staff to excel.

Full Text (http://medicaleconomics.modernmedicine.com/medical-economics/news/how-physicians-can-increase-employee-satisfaction-their-medical-practice?page=0,0 )

Health Worker Roles Impacted When 'Undervalued' by Patients

FRIDAY, Sept. 27 (HealthDay News) -- Job satisfaction among nurse practitioners and other professionals can suffer when clientele lack a clear understanding of what they do, according to research published in the Aug. 1 issue of the Academy of Management Journal.

Abstract (http://amj.aom.org/content/56/4/1050.abstract )Full Text (subscription or payment may be required) (http://amj.aom.org/content/56/4/1050.full )

HEALTH REFORM: ACA Impact on Medicare Recipients Unclear

FRIDAY, Sept. 27 (HealthDay News) -- The Affordable Care Act (ACA) will help millions of uninsured Americans access affordable health care coverage, but it's unclear what effect the law will have on people covered by Medicare.

More Information (https://www.healthcare.gov/ )

HEALTH REFORM: Medicaid Expansion Will Up Coverage

THURSDAY, Sept. 26 (HealthDay News) -- Two aspects of the Affordable Care Act (ACA) have the potential to extend health insurance coverage to those who do not qualify for government-sponsored health care but cannot afford to purchase private plans.

More Information (https://www.healthcare.gov/ )

CDC: Flu Shot Coverage of Health Care Personnel Increasing

THURSDAY, Sept. 26 (HealthDay News) -- Influenza vaccination coverage has increased among health care personnel but varies by occupation type and occupational setting, according to a report published in the Sept. 27 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

Full Text (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6238a2.htm?s_cid=mm6238a2_w )

HEALTH REFORM: Exchanges Offer Options for the Uninsured

WEDNESDAY, Sept. 25 (HealthDay News) -- Millions of part-time, seasonal, self-employed workers and other individuals currently without health insurance may find a solution to their vulnerable status when the new health care exchanges go into effect on Oct. 1.

More Information (https://www.healthcare.gov/ )

More Options, Lower Premiums With Insurance Exchanges

WEDNESDAY, Sept. 25 (HealthDay News) -- Consumers are likely to find insurance options more plentiful and more affordable than expected in the new Health Insurance Marketplace that goes into effect Oct. 1, according to a report released Sept. 25 by the U.S. Department of Health and Human Services.

More Information (http://www.hhs.gov/news/press/2013pres/09/20130925a.html )

Dextrose Gel Reverses Hypoglycemia in Neonates

WEDNESDAY, Sept. 25 (HealthDay News) -- Dextrose gel may be used to manage hypoglycemia in late preterm and term babies in the first 48 hours following birth, according to research published online Sept. 25 in The Lancet.

Abstract (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61645-1/abstract )Full Text (subscription or payment may be required) (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61645-1/fulltext )Editorial (subscription or payment may be required) (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61755-9/fulltext )

ACP Provides Overview of Health Insurance Marketplaces

WEDNESDAY, Sept. 25 (HealthDay News) -- The opportunities and challenges presented by health care reform are discussed in an article published online Sept. 24 in the Annals of Internal Medicine.

Full Text (http://annals.org/article.aspx?articleid=1741855 )

HEALTH REFORM: Health Care Reform a Mixed Bag for Workers

TUESDAY, Sept. 24 (HealthDay News) -- Much discussion of the Affordable Care Act revolves around the dramatic changes in store for America's uninsured, but the health care reform law will also have an impact on individuals with employer-based coverage.

More Information (https://www.healthcare.gov/ )

FDA Gives Final Guidance on Mobile Medical App Oversight

TUESDAY, Sept. 24 (HealthDay News) -- The U.S. Food and Drug Administration issued final guidance for mobile application (app) developers, and is focusing its oversight on medical apps that will be used as accessories to regulated medical devices, or that transform a mobile device into a regulated medical device.

More Information (http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm369431.htm )

Medicare Expenditure Per Patient Up for Acute MI

TUESDAY, Sept. 24 (HealthDay News) -- For patients with acute myocardial infarction (AMI), Medicare expenditures per patient increased significantly from 1998-1999 to 2008, according to research published online Sept. 23 in JAMA Internal Medicine.

Full Text (http://archinte.jamanetwork.com/article.aspx?articleid=1740698 )Editorial (http://archinte.jamanetwork.com/article.aspx?articleid=1740695 )

Model Can Predict Preemie Neonatal Outcome Severity

TUESDAY, Sept. 24 (HealthDay News) -- A statistical prediction model comprising eight characteristics can be used to determine the severity of neonatal outcomes for infants born at 23 to 30 weeks of gestation, according to a study published online Sept. 23 in Pediatrics.

Abstract (http://pediatrics.aappublications.org/content/early/2013/09/18/peds.2013-0702.abstract )Full Text (subscription or payment may be required) (http://pediatrics.aappublications.org/content/early/2013/09/18/peds.2013-0702.full.pdf+html )

FDA Issues Final Rule for Device Identification System

MONDAY, Sept. 23 (HealthDay News) -- The U.S. Food and Drug Administration has released a final rule for the unique device identification system (UDI) that, when implemented, will improve patient safety by providing a consistent way to identify approved medical devices.

More Information (http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm369276.htm )

HEALTH REFORM: Young People Likely to Be Key to Success

MONDAY, Sept. 23 (HealthDay News) -- Young, healthy adults are considered key to the success of health insurance reform, but many are not even aware of state insurance exchanges.

More Information (https://www.healthcare.gov/ )

HEALTH REFORM: Health Care Exchanges Going Into Effect

MONDAY, Sept. 23 (HealthDay News) -- As of Oct. 1, consumers looking for health insurance will be able to turn to state-based health care exchanges, a centerpiece of the Affordable Care Act intended to help the uninsured and small businesses find affordable coverage.

More Information (https://www.healthcare.gov/ )

Use of Digoxin Ups Risk of Death in Systolic Heart Failure

MONDAY, Sept. 23 (HealthDay News) -- Digoxin therapy was independently associated with increased mortality in patients with systolic heart failure, according to research published in the September issue of Circulation: Cardiovascular Quality and Outcomes.

Abstract (http://circoutcomes.ahajournals.org/content/6/5/525.abstract )Full Text (http://circoutcomes.ahajournals.org/content/6/5/525.full )

Majority of U.S. Consumers Want Full Access to EMR

MONDAY, Sept. 23 (HealthDay News) -- Most U.S. consumers want to have full access to their electronic medical records (EMR), and 41 percent would be willing to switch doctors to gain access, according to a survey published by Accenture.

More Information (http://newsroom.accenture.com/news/more-than-40-percent-of-us-consumers-willing-to-switch-physicians-to-gain-online-access-to-electronic-medical-records-according-to-accenture-survey.htm?c=hls_fy13prtwt_10000108&n=smc_0713#sf17115649g )

New Model Better Predicts Risk of Post-PCI Bleeding

FRIDAY, Sept. 20 (HealthDay News) -- A new definition of post-percutaneous coronary intervention (PCI) bleeding and a new predictive risk model can better identify patients at risk for bleeding complications, according to a study published in the September issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

Abstract (http://interventions.onlinejacc.org/article.aspx?articleid=1738800#Abstract )Full Text (http://interventions.onlinejacc.org/article.aspx?articleid=1738800 )

New Medicaid Enrollees Under ACA May Be Healthier

THURSDAY, Sept. 19 (HealthDay News) -- Adults potentially eligible for Medicaid under the Patient Protection and Affordable Care Act (ACA) are expected to have equal or better health status than current beneficiaries, according to research published in the September/October issue of the Annals of Family Medicine.

Abstract (http://www.annfammed.org/content/11/5/406.full )Full Text (http://www.annfammed.org/content/11/5/406.full )Editorial 1 (http://www.annfammed.org/content/11/5/402.full )Editorial 2 (http://www.annfammed.org/content/11/5/400.full )

Pros and Cons of Shortening Medical School Discussed

THURSDAY, Sept. 19 (HealthDay News) -- The pros and cons of shortening medical school to three years are discussed in two perspective pieces published in the Sept. 19 issue of the New England Journal of Medicine.

Full Text - Abramson (http://www.nejm.org/doi/full/10.1056/NEJMp1304681 )Full Text - Goldfarb and Morrison (http://www.nejm.org/doi/full/10.1056/NEJMp1306457 )

Millions Are Harmed by Unsafe Medical Care Each Year

THURSDAY, Sept. 19 (HealthDay News) -- Adverse events caused by inferior medical care are a major source of morbidity and mortality globally, according to research published in the October issue of BMJ Quality & Safety.

Abstract (http://qualitysafety.bmj.com/content/22/10/809.abstract )Full Text (http://qualitysafety.bmj.com/content/22/10/809.full )Editorial (http://qualitysafety.bmj.com/content/22/10/798.full )

High-Volume Hospitals Have Fewer Surgical Readmissions

WEDNESDAY, Sept. 18 (HealthDay News) -- Hospitals with a high volume of surgeries and low surgical mortality rates have lower rates of surgical readmission than other hospitals, according to research published in the Sept. 19 issue of the New England Journal of Medicine.

Full Text (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMsa1303118 )

Enhanced Care Program Set Up at Six Mayo Clinic Hospitals

WEDNESDAY, Sept. 18 (HealthDay News) -- A new program has been developed and implemented at six Mayo Clinic Health System hospitals to improve care and shorten hospital stays using remote monitoring, according to a press release issued by the Mayo Clinic.

More Information (http://www.mayoclinic.org/news2013-rst/7666.html )

EHR Systems Meeting Meaningful Use Criteria Beneficial

WEDNESDAY, Sept. 18 (HealthDay News) -- Most electronic health record (EHR) systems meet meaningful use criteria, and these systems are associated with time-saving and other benefits, according to a September data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

More Information (http://www.cdc.gov/nchs/data/databriefs/db129.htm )

Payment for Routine Office Visits Varies Substantially

WEDNESDAY, Sept. 18 (HealthDay News) -- There is substantial variation in private insurance payment to physicians for routine office visits, according to research published in the September issue of Health Affairs.

Abstract (http://content.healthaffairs.org/content/32/9/1583.abstract )Full Text (subscription or payment may be required) (http://content.healthaffairs.org/content/32/9/1583.full )

More Than 1.6 Million Americans Expected to Get Cancer in 2013

TUESDAY, Sept. 17 (HealthDay News) -- Although significant progress has been made in treating cancer, more than 1.6 million Americans are projected to receive a cancer diagnosis in 2013, according to the third American Association for Cancer Research's Cancer Progress Report 2013.

More Information (http://cancerprogressreport.org/2013/pages/toc.aspx )

Americans Living Longer, Healthier Lives

MONDAY, Sept. 16 (HealthDay News) -- Health surveys show that quality-adjusted life expectancy has increased by about two years in U.S. adults over the past 20 years, according to research published online Sept. 12 in the American Journal of Public Health.

Abstract (http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2013.301250 )Full Text (subscription or payment may be required) (http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2013.301250 )

CDC Report Sheds Light on Antibiotic-Resistant Infections

MONDAY, Sept. 16 (HealthDay News) -- Antibiotic-resistant infections claim the lives of 23,000 people in the United States every year and take a tremendous financial toll on the already overburdened health care system, according to a report issued Sept. 16 by the U.S. Centers for Disease Control and Prevention.

More Information (http://www.cdc.gov/media/releases/2013/p0916-untreatable.html )

Mindfulness Training Beneficial for Clinicians, Patients

THURSDAY, Sept. 12 (HealthDay News) -- Mindfulness training is associated with improvements in physician burnout; and, clinicians who rate themselves as more mindful engage in more patient-centered communication, according to two studies published in the September/October issue of the Annals of Family Medicine.

Abstract - Fortney (http://www.annfammed.org/content/11/5/412.abstract )Full Text (http://www.annfammed.org/content/11/5/412.full )Abstract - Beach (http://www.annfammed.org/content/11/5/421.abstract )Full Text (http://www.annfammed.org/content/11/5/421.full )

Prevalence of Hospitalization Due to Hypertensive Disease Up

TUESDAY, Sept. 10 (HealthDay News) -- From 1980 to 2007, the prevalence of hospitalization attributable to hypertensive disease increased for U.S. adults, according to a study published in the Sept. 1 issue of The American Journal of Cardiology.

Abstract (http://www.ajconline.org/article/S0002-9149(13)01067-9/abstract )Full Text (subscription or payment may be required) (http://www.ajconline.org/article/S0002-9149(13)01067-9/fulltext )

About Half of Health Care Providers Are 'Digital Omnivores'

TUESDAY, Sept. 10 (HealthDay News) -- About half of health care providers are "digital omnivores," meaning they use a tablet, smartphone, and laptop/desktop computer routinely in a professional capacity, according to a report published by Epocrates.

More Information (http://www.epocrates.com/oldsite/statistics/2013%20Epocrates%20Mobile%20Trends%20Report_FINAL.pdf )

Treatment in Critical Care Often Perceived As Futile

TUESDAY, Sept. 10 (HealthDay News) -- Intensive care unit (ICU) treatment is frequently perceived as futile by critical care specialists, and entails considerable costs, according to a study published online Sept. 9 in JAMA Internal Medicine.

Full Text (http://archinte.jamanetwork.com/article.aspx?articleid=1735897 )Editorial (http://archinte.jamanetwork.com/article.aspx?articleid=1735891 )

'Meaningful Use' Achievement Not Uniform Across Hospitals

MONDAY, Sept. 9 (HealthDay News) -- In regard to the adoption of electronic health records (EHRs), achievement of "meaningful use" criteria is not uniform across all hospitals, according to a study published in the August issue of Health Affairs.

Abstract (http://content.healthaffairs.org/content/32/8/1355?=right )Full Text (subscription or payment may be required) (http://content.healthaffairs.org/content/32/8/1355.full )

Most Physicians Report Being Satisfied With Career Choice

MONDAY, Sept. 9 (HealthDay News) -- Most physicians report being satisfied with their career choice, although 40 percent would rethink their path given the chance to choose again, according to the 2013 Great American Physician Survey published in Physicians Practice.

More Information (http://www.physicianspractice.com )

Intervention for NICU Moms Reduces Their Trauma, Anxiety

THURSDAY, Sept. 5 (HealthDay News) -- An intervention aimed at reducing parental trauma and redefining the parental experience for those with very premature newborns is both feasible and cost-effective, according to a study published online Sept. 2 in Pediatrics.

Abstract (http://pediatrics.aappublications.org/content/early/2013/08/28/peds.2013-1331 )Full Text (subscription or payment may be required) (http://pediatrics.aappublications.org/content/early/2013/08/28/peds.2013-1331.full.pdf+html )

Major Health Care-Linked Infections Cost $9.8 Billion

WEDNESDAY, Sept. 4 (HealthDay News) -- The total annual cost associated with the five major health care-associated infections (HAIs) is $9.8 billion, according to a meta-analysis published online Sept. 2 in JAMA Internal Medicine.

Abstract (http://archinte.jamanetwork.com/article.aspx?articleid=1733452#Abstract )Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1733452 )Editorial (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1733445 )

Docs' Confidence in Diagnosis Unrelated to Diagnostic Accuracy

TUESDAY, Sept. 3 (HealthDay News) -- Physicians' confidence in their diagnostic accuracy is not associated with actual diagnostic accuracy or with case difficulty, according to a study published online Aug. 26 in JAMA Internal Medicine.

Abstract (http://archinte.jamanetwork.com/article.aspx?articleid=1731967#Abstract )Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1731967 )Editorial (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1731959 )

CDC: 200,000 Avoidable Deaths From Cardiovascular Disease

TUESDAY, Sept. 3 (HealthDay News) -- There were about 200,000 avoidable deaths from cardiovascular disease in 2010 in the United States, with deaths occurring disproportionately among those over 65 years old, males, non-Hispanic blacks, and those in the South, according to a report published in the Sept. 3 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

More Information (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm62e0903a1.htm?s_cid=mm62e0903a1_w )

Male-Female Physician Earnings Gap Has Persisted for 20 Years

TUESDAY, Sept. 3 (HealthDay News) -- For physicians, the male-female earnings gap has not changed significantly since 1987, according to a research letter published online Sept. 2 in JAMA Internal Medicine.

Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1733450 )Editorial (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1733448 )

Employer-Based Health Insurance Premiums Rose Modestly in 2013

MONDAY, Sept. 2 (HealthDay News) -- Employer-sponsored health insurance premiums rose only modestly in 2013, according to research published in the August issue of Health Affairs.

Abstract (http://content.healthaffairs.org/content/early/2013/08/16/hlthaff.2013.0644 )Full Text (subscription or payment may be required) (http://content.healthaffairs.org/content/early/2013/08/16/hlthaff.2013.0644.full )

Workaholics Have Poorer Physical and Mental Health

MONDAY, Sept. 2 (HealthDay News) -- Workaholics, defined as those who work more than 50 hours per week, have reduced physical and mental well-being, according to researchers from Kansas State University.

Press Release (http://www.k-state.edu/media/newsreleases/aug13/workaholics82213.html )