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Monday, June 24, 2013
Thursday, May 16, 2013
Cancer funding will save lives: Stricker
About 3200 men die annually from prostate cancer but with the injection of the federal money, which will be split between three research institutes in NSW, Victoria and Queensland, more effective and less invasive treatments will be developed, Professor Phillip Stricker from Sydney's Kinghorn Cancer Centre said.
"It's a matter of how many lives you save but also how many people you don't hurt (with invasive treatment)," Prof Stricker told reporters on Friday.
"It's a matter of tailoring the treatment."
The Kinghorn Cancer Centre will receive $5.5 million of the money, which Prof Stricker said will fund research in genomics.
Researchers will study the genes of various groups as they seek to uncover potential predispositions to prostate cancer, which affects one-in-five men by the age of 85.
This information can then be used to target people with higher risks and start them on less-invasive preventative treatment, Prof Stricker said.
The remainder of the federal research money will be split between the Epworth Hospital in Melbourne and the Princess Alexandra Hospital in Brisbane with each due to receive $6.2 million.
Federal Health Minister Tanya Plibersek said the money was provided to "make sure that Australian patients get the best possible treatment".
The government also committed $656 million to building 25 regional cancer centres across the country.
Ms Plibersek said this will "ensure that people can access early detection, treatment and quality care, where and when they need it".
"It's a matter of how many lives you save but also how many people you don't hurt (with invasive treatment)," Prof Stricker told reporters on Friday.
"It's a matter of tailoring the treatment."
The Kinghorn Cancer Centre will receive $5.5 million of the money, which Prof Stricker said will fund research in genomics.
Researchers will study the genes of various groups as they seek to uncover potential predispositions to prostate cancer, which affects one-in-five men by the age of 85.
This information can then be used to target people with higher risks and start them on less-invasive preventative treatment, Prof Stricker said.
The remainder of the federal research money will be split between the Epworth Hospital in Melbourne and the Princess Alexandra Hospital in Brisbane with each due to receive $6.2 million.
Federal Health Minister Tanya Plibersek said the money was provided to "make sure that Australian patients get the best possible treatment".
The government also committed $656 million to building 25 regional cancer centres across the country.
Ms Plibersek said this will "ensure that people can access early detection, treatment and quality care, where and when they need it".
Friday, April 12, 2013
Study Reveals Why You Can't Stop At Just One Potato Chip
Everyone will agree that eating potato chips is addictive. It is impossible to eat just one when it comes to this deep-fried delight. Have you ever given it a thought as to what is the secret underpinning the reality about one's non-resistance to potato chips?
The scientific secret behind this is being provided by a team of researchers at FAU Erlangen Nuremberg, in Erlangen, Germany. According to Tobais Hoch, Ph.D, the study lead, 'hedonic hyperphagia' is a condition that plagues several people around the world.
Hedonic hyperphagia is the scientific term for recreational over-eating. It is used to describe eating in excess for pleasure rather than hunger.
To prove this, researchers conducted a study in which they allowed a group of laboratory rats to feast on potato chips and another group of rats got to eat bland rat chow. With the help of high-tech magnetic resonance imaging (MRI), they checked the difference in the brain activity of both groups. The rats were given one out of the three test foods along with their chow pellets. They were given animal chow, a mix of fat and carbs or potato chips. It was seen that the rats ate similar amounts of chow as well as chips and the fat carb mixture. But the rats actively hunted for potato chips and ate them. This showed that the ingredient in the chips was more interesting for rats than the carbs and fat mix.
The researchers suspect the high ratio of fat and carbohydrates to be the reason behind why people are attracted to these food items.
"The effect of potato chips on brain activity, as well as feeding behavior, can only partially be explained by its fat and carbohydrate content," explained Hoch in a press statement. "There must be something else in the chips that make them so desirable," he said.
During the MRI they observed that the reward and addiction centers in the brain had most of the activity. Eating potato chips significantly stimulated the food intake, sleep, activity and motion areas of the brain.
The study was presented at a meeting of the American Chemical Society.
The scientific secret behind this is being provided by a team of researchers at FAU Erlangen Nuremberg, in Erlangen, Germany. According to Tobais Hoch, Ph.D, the study lead, 'hedonic hyperphagia' is a condition that plagues several people around the world.
Hedonic hyperphagia is the scientific term for recreational over-eating. It is used to describe eating in excess for pleasure rather than hunger.
To prove this, researchers conducted a study in which they allowed a group of laboratory rats to feast on potato chips and another group of rats got to eat bland rat chow. With the help of high-tech magnetic resonance imaging (MRI), they checked the difference in the brain activity of both groups. The rats were given one out of the three test foods along with their chow pellets. They were given animal chow, a mix of fat and carbs or potato chips. It was seen that the rats ate similar amounts of chow as well as chips and the fat carb mixture. But the rats actively hunted for potato chips and ate them. This showed that the ingredient in the chips was more interesting for rats than the carbs and fat mix.
The researchers suspect the high ratio of fat and carbohydrates to be the reason behind why people are attracted to these food items.
"The effect of potato chips on brain activity, as well as feeding behavior, can only partially be explained by its fat and carbohydrate content," explained Hoch in a press statement. "There must be something else in the chips that make them so desirable," he said.
During the MRI they observed that the reward and addiction centers in the brain had most of the activity. Eating potato chips significantly stimulated the food intake, sleep, activity and motion areas of the brain.
The study was presented at a meeting of the American Chemical Society.
Friday, March 22, 2013
CVS requirement for employees to turn over health info part of greater trend in health insurance
A plan by a major drug store chain to penalize employees who don't turn over health information may be new, but the trend to get unhealthy people to pay - and pay more - for their health insurance is not.
CVS Caremark Inc., which operates dozens of drug stores in the region and a pharmacy fulfillment center in Hanover Township, will require employees under its health insurance plan get an annual checkup and disclose to the company health statistics such as weight, body mass index and blood sugar or face a $50 per month surcharge for health care.
A statement issued by the Woonsocket, R.I.-based company said the program "is evolving to help our colleagues take more responsibility for improving their health and managing health-associated costs."
This is not the eve of a new era of premium differentials and risk ratings, said Nate Kaufman, managing director of Kaufman Strategic Advisors. That era is already here.
Hospitals are refusing to hire smokers, group insurance plans have long offered financial incentives to those who get regular health assessments or even those who go the gym. The federal Affordable Care Act will cost smokers more, he noted. Whether a company is charging the healthy less or the unhealthy more, it's the other side of the same coin.
"Those are precursors to what we are seeing now - follow health advice or there will be a differential," said Kaufman, who spoke at Misericordia University last year about health care costs.
Those buying individual insurance have long been subjected to more probing scrutiny, he noted, with an insurer assessing not just an individual's use of tobacco, weight, blood pressure, but also every visit to a health care provider going back years, which sometimes veers into more sensitive areas.
"If you've ever visited a psychologist, for example, you may end up with a higher risk ranking and a higher premium," he said.
Those same risk rankings and differentials are coming to group plans, where the unhealthy or those who used lots of services were blended with a larger group. An employer offering group insurance to employees negotiates premiums with insurance companies. Adopting wellness incentives usually results in a lower-cost insurance plan for all.
Health insurers say the terms of the wellness incentives come from the employer, in consultation with the insurance companies. Both Geisinger and Blue Cross of Northeastern Pennsylvania offer wellness plans that includes health planning and coaching connected to incentives from discounts and refunds to gift cards.
"There is nothing unusual about what CVS is doing," said Mark Ungvarsky, vice president of informatics for Blue Cross of Northeastern Pennsylvania. "The reality is that we see more and more groups telling us 'we want our insured employees to have some accountability.'"
Blue Cross wellness programs are based on incentives rather than penalties, because that's how employer groups request it. Ungvarsky said the perception of those plans has much to do with how the program packaged, but in the end, some pay less or get a benefit and others don't.
Among the 400,000 people covered by Geisinger Health Plan, 50,000 in 40 employer group are in some form of Geisinger's wellness plan often called Smart Steps, said Amy Bowen, public relations specialist for Geisinger Health Plan. Thirteen other groups are considering it.
CVS Caremark Inc., which operates dozens of drug stores in the region and a pharmacy fulfillment center in Hanover Township, will require employees under its health insurance plan get an annual checkup and disclose to the company health statistics such as weight, body mass index and blood sugar or face a $50 per month surcharge for health care.
A statement issued by the Woonsocket, R.I.-based company said the program "is evolving to help our colleagues take more responsibility for improving their health and managing health-associated costs."
This is not the eve of a new era of premium differentials and risk ratings, said Nate Kaufman, managing director of Kaufman Strategic Advisors. That era is already here.
Hospitals are refusing to hire smokers, group insurance plans have long offered financial incentives to those who get regular health assessments or even those who go the gym. The federal Affordable Care Act will cost smokers more, he noted. Whether a company is charging the healthy less or the unhealthy more, it's the other side of the same coin.
"Those are precursors to what we are seeing now - follow health advice or there will be a differential," said Kaufman, who spoke at Misericordia University last year about health care costs.
Those buying individual insurance have long been subjected to more probing scrutiny, he noted, with an insurer assessing not just an individual's use of tobacco, weight, blood pressure, but also every visit to a health care provider going back years, which sometimes veers into more sensitive areas.
"If you've ever visited a psychologist, for example, you may end up with a higher risk ranking and a higher premium," he said.
Those same risk rankings and differentials are coming to group plans, where the unhealthy or those who used lots of services were blended with a larger group. An employer offering group insurance to employees negotiates premiums with insurance companies. Adopting wellness incentives usually results in a lower-cost insurance plan for all.
Health insurers say the terms of the wellness incentives come from the employer, in consultation with the insurance companies. Both Geisinger and Blue Cross of Northeastern Pennsylvania offer wellness plans that includes health planning and coaching connected to incentives from discounts and refunds to gift cards.
"There is nothing unusual about what CVS is doing," said Mark Ungvarsky, vice president of informatics for Blue Cross of Northeastern Pennsylvania. "The reality is that we see more and more groups telling us 'we want our insured employees to have some accountability.'"
Blue Cross wellness programs are based on incentives rather than penalties, because that's how employer groups request it. Ungvarsky said the perception of those plans has much to do with how the program packaged, but in the end, some pay less or get a benefit and others don't.
Among the 400,000 people covered by Geisinger Health Plan, 50,000 in 40 employer group are in some form of Geisinger's wellness plan often called Smart Steps, said Amy Bowen, public relations specialist for Geisinger Health Plan. Thirteen other groups are considering it.
Tuesday, February 19, 2013
New dietary guidelines all about balance
Australia's new dietary guidelines hold no unexpected plot twists. You still need to eat more vegetables, fruit and whole grains, and fewer unhealthy junk foods, those which are high salt, sugar and saturated fat.
But putting physical activity at the top of dietary guidelines is a bit of surprise. In the past, the guidelines have focused on what food and drink you need to include in a healthy diet, but now the focus is about 'energy balance'.
It might sound like gobbledegook, but the idea of 'energy balance' simply means making sure the energy you get from food and drink is no more than the energy your body needs to maintain a healthy weight. Obviously, your age, gender, height and level of physical activity all play a role in the amount of energy you need.
With more than 60 per cent of adults and 25 per cent of children overweight and obese this is something many of us need to consider more. (For more information see Being overweight or obese: what does it mean for you?).
And when it comes to food, it's not just about what you eat, but how much, says Professor Warwick Anderson, the chief executive officer at the National Health and Medical Research Council, which published the guidelines.
"We can eat as many leafy vegetables as we like without risk of eating too many kilojoules," Anderson says. "But some other foods, which are healthy in themselves, such as full fat milk and cheese, may also be high in kilojoules and therefore they can tip us over in the daily kilojoule requirement if we eat too much of those.
"If people have a better understanding of this need for energy balance, they can apply that concept to their daily lives as they make choices regarding activity levels as well as healthy food options."
Physical activity
Not only has physical activity been given greater prominence in the current guidelines, but the advice is we need to do more of it if we want to avoid weight gain.
Nutritionist Dr Rosemary Stanton, who sat on the dietary guidelines working committee, says when previous dietary guidelines were written it was recommended we do between 20 to 30 minutes of physical activity every day. That's now been increased to between 45 and 60 minutes, Stanton says, (although that's yet to be reflected in revised national exercise guidelines).
"In the previous guidelines it was about reducing cardiovascular risk. When we're looking at obesity, the amount of exercise you require is greater," Stanton says.
Physical activity is mentioned high up in the new dietary advice, as part of guideline one.
"Some people want to put them against each other and... say 'physical activity is more important' or 'all you need to is diet'," Stanton says. "But both are going to be important."
But putting physical activity at the top of dietary guidelines is a bit of surprise. In the past, the guidelines have focused on what food and drink you need to include in a healthy diet, but now the focus is about 'energy balance'.
It might sound like gobbledegook, but the idea of 'energy balance' simply means making sure the energy you get from food and drink is no more than the energy your body needs to maintain a healthy weight. Obviously, your age, gender, height and level of physical activity all play a role in the amount of energy you need.
With more than 60 per cent of adults and 25 per cent of children overweight and obese this is something many of us need to consider more. (For more information see Being overweight or obese: what does it mean for you?).
And when it comes to food, it's not just about what you eat, but how much, says Professor Warwick Anderson, the chief executive officer at the National Health and Medical Research Council, which published the guidelines.
"We can eat as many leafy vegetables as we like without risk of eating too many kilojoules," Anderson says. "But some other foods, which are healthy in themselves, such as full fat milk and cheese, may also be high in kilojoules and therefore they can tip us over in the daily kilojoule requirement if we eat too much of those.
"If people have a better understanding of this need for energy balance, they can apply that concept to their daily lives as they make choices regarding activity levels as well as healthy food options."
Physical activity
Not only has physical activity been given greater prominence in the current guidelines, but the advice is we need to do more of it if we want to avoid weight gain.
Nutritionist Dr Rosemary Stanton, who sat on the dietary guidelines working committee, says when previous dietary guidelines were written it was recommended we do between 20 to 30 minutes of physical activity every day. That's now been increased to between 45 and 60 minutes, Stanton says, (although that's yet to be reflected in revised national exercise guidelines).
"In the previous guidelines it was about reducing cardiovascular risk. When we're looking at obesity, the amount of exercise you require is greater," Stanton says.
Physical activity is mentioned high up in the new dietary advice, as part of guideline one.
"Some people want to put them against each other and... say 'physical activity is more important' or 'all you need to is diet'," Stanton says. "But both are going to be important."
Monday, January 28, 2013
Think preventive medicine will save money? Think again
It seems like a no-brainer. Since about 75 percent of healthcare spending in the United States is for largely preventable chronic illnesses such as Type 2 diabetes and heart disease, providing more preventive care should cut costs.
If only. In a report released on Tuesday, the non-profit Trust for America's Health outlined a plan "to move from sick care to health care" by putting more resources into preventing chronic disease rather than treating it, as the current system does.
There is a strong humanitarian justification for prevention, argued Trust Executive Director Jeffrey Levi in an interview, since it reduces human suffering. But the report also makes an economic argument for preventive care, highlighting the possibility of reducing healthcare spending -- which in 2011 reached $2.7 trillion, just shy of 18 percent of gross domestic product -- by billions of dollars. And that has health economists shaking their heads.
"Preventive care is more about the right thing to do" because it spares people the misery of illness, said economist Austin Frakt of Boston University. "But it's not plausible to think you can cut healthcare spending through preventive care. This is widely misunderstood." A 2010 study in the journal Health Affairs, for instance, calculated that if 90 percent of the U.S. population used proven preventive services, more than do now, it would save only 0.2 percent of healthcare spending.
Some disease-prevention programs do produce net savings. Childhood immunizations, and probably some adult immunizations (such as for pneumonia and the flu), are cost-saving, found a 2009 analysis for the Robert Wood Johnson Foundation.
The vaccines are cheap, and large swaths of the population are vulnerable to the diseases they prevent. The cost of providing them to everyone is less than that of treating the illnesses they prevent. Counseling adults about using baby aspirin to prevent cardiovascular disease also produces net savings. The counseling is inexpensive, the aspirin even cheaper and the costs of heart disease, which strikes one in three U.S. adults, are enormous. Screening pregnant women for HIV produces net savings, too. Those, however, are exceptions.
One big reason why preventive care does not save money, say health economists, is that some of the best-known forms don't actually improve someone's health. These low- or no-benefit measures include annual physicals for healthy adults. A 2012 analysis of 14 large studies found they do not lower the risk of serious illness or premature death. But about one-third of U.S. adults get them, said Dr. Ateev Mehrota, a primary-care physician and healthcare analyst at RAND, for a cost of about $8 billion a year. Similarly, some cancer screenings -- including for ovarian cancer and testicular cancer, and for prostate cancer via PSA tests -- produce essentially no health benefits, causing the U.S. Preventive Services Task Force to recommend against their routine use. The task force bases its recommendations on medical benefits alone, not costs.
The second reason preventive care brings so few cost savings is the large number of people who need to receive a particular preventive service in order to avert a single expensive illness. "It seems counterintuitive: If you provide care to prevent all these expensive diseases, it should save money," said Peter Neumann, an expert on health policy and professor of medicine at Tufts University School of Medicine.
"But prevention itself costs money, and some preventive measures can be very expensive, especially if you give them to a lot of people who won't benefit." If preventive care could be provided only to those who are going to get the illness, it would be more cost-effective. "But in the real world, the number needed to screen or to treat in order to prevent one case of illness can be huge," said BU's Frakt, who blogs at theincidentaleconomist.com. Currently, many people who do not benefit from a preventive service receive it, paying something for nothing. Studies have calculated those numbers, which can be surprisingly high.
For instance, 217 high-risk smokers would have to undergo a CT lung scan for one to be spared death from lung cancer, according to a database of studies maintained by Dr. David Newman, an emergency physician at Mount Sinai School of Medicine in New York City. One hundred post-menopausal women who have had a bone fracture would have to take drugs called bisphosphonates in order for one to avoid a hip fracture. By comparison, only 50 people with heart disease must be treated with aspirin for one to avoid a heart attack or stroke, making this a good buy.
The numbers of people who need to be treated for one to benefit are so high because so few will get the disease the preventive is meant to avert. It's like treating every house for termites, said Neumann, co-author of the Robert Wood Johnson report: The vast majority would never have gotten infested in the first place, so the thousands spent to avoid the infestation is money for nothing. The failure of many preventive services to improve health, plus the large number of people who have to receive preventive care for one to be spared an illness he or she would otherwise get, limit the economic savings.
A better gauge of the value of preventive medicine is bang for the buck; that is, not whether it reduces healthcare spending but whether it buys more health than treating the disease does. "We don't ask whether cancer treatment or heart disease treatment saves money," said Dr. Steven Woolf, professor of family medicine at Virginia Commonwealth University Medical Center in Richmond. "But it is reasonable to ask how to make our healthcare dollar go further." On that score, screening for hypertension and for some cancers (such as colorectal and breast) are good investments, he said, at less than $25,000 per year of healthy life. In contrast, such common treatments as angioplasty cost $100,000 or more per healthy year of life.
There are two glimmers of hope in this bleak picture. For preventive medicine to help rein in the nation's soaring healthcare spending, it should be provided someplace other than doctors' offices. "Some of the most common chronic, preventable diseases might be best addressed outside the clinical setting," said the Trust's Levi, such as through wellness programs at YMCAs and health education and screening programs at houses of worship. "But that requires Medicaid to be more flexible in who they'll reimburse." It also requires a more expansive definition of preventive medicine.
The Trust suggests such steps as extending bus lines to parks so people without cars can go someplace pleasant for physical activity and other "community-based" efforts. These strategies save more money in healthcare spending than they cost. For instance, at a program in Akron, Ohio, profiled in the new report, physicians and others coordinate care for patients with Type 2 diabetes. It reduced the average cost of care by more than 10 percent, or $3,185 per year, largely by reducing pricey emergency-room visits.
And at Boston Children's Hospital, an asthma program that sends community health workers into patients' homes to reduce the environmental triggers of asthma has saved $1.46 in healthcare costs for every $1 invested. It has reduced asthma-related hospital admissions by 80 percent and asthma-related emergency department visits by 60 percent, reports the Trust.
The other promising approach is to target preventive care at those most likely to develop a chronic disease, not at low-risk people. Such "smart" prevention increases the chances of preventing expensive diseases and saving money. In contrast, unthinking expansion of preventive medicine is the wrong prescription, say experts. "If you start giving preventive care to more people, many of whom won't benefit from it, it's going to be very, very expensive," said Tufts' Neumann.
If only. In a report released on Tuesday, the non-profit Trust for America's Health outlined a plan "to move from sick care to health care" by putting more resources into preventing chronic disease rather than treating it, as the current system does.
There is a strong humanitarian justification for prevention, argued Trust Executive Director Jeffrey Levi in an interview, since it reduces human suffering. But the report also makes an economic argument for preventive care, highlighting the possibility of reducing healthcare spending -- which in 2011 reached $2.7 trillion, just shy of 18 percent of gross domestic product -- by billions of dollars. And that has health economists shaking their heads.
"Preventive care is more about the right thing to do" because it spares people the misery of illness, said economist Austin Frakt of Boston University. "But it's not plausible to think you can cut healthcare spending through preventive care. This is widely misunderstood." A 2010 study in the journal Health Affairs, for instance, calculated that if 90 percent of the U.S. population used proven preventive services, more than do now, it would save only 0.2 percent of healthcare spending.
Some disease-prevention programs do produce net savings. Childhood immunizations, and probably some adult immunizations (such as for pneumonia and the flu), are cost-saving, found a 2009 analysis for the Robert Wood Johnson Foundation.
The vaccines are cheap, and large swaths of the population are vulnerable to the diseases they prevent. The cost of providing them to everyone is less than that of treating the illnesses they prevent. Counseling adults about using baby aspirin to prevent cardiovascular disease also produces net savings. The counseling is inexpensive, the aspirin even cheaper and the costs of heart disease, which strikes one in three U.S. adults, are enormous. Screening pregnant women for HIV produces net savings, too. Those, however, are exceptions.
One big reason why preventive care does not save money, say health economists, is that some of the best-known forms don't actually improve someone's health. These low- or no-benefit measures include annual physicals for healthy adults. A 2012 analysis of 14 large studies found they do not lower the risk of serious illness or premature death. But about one-third of U.S. adults get them, said Dr. Ateev Mehrota, a primary-care physician and healthcare analyst at RAND, for a cost of about $8 billion a year. Similarly, some cancer screenings -- including for ovarian cancer and testicular cancer, and for prostate cancer via PSA tests -- produce essentially no health benefits, causing the U.S. Preventive Services Task Force to recommend against their routine use. The task force bases its recommendations on medical benefits alone, not costs.
The second reason preventive care brings so few cost savings is the large number of people who need to receive a particular preventive service in order to avert a single expensive illness. "It seems counterintuitive: If you provide care to prevent all these expensive diseases, it should save money," said Peter Neumann, an expert on health policy and professor of medicine at Tufts University School of Medicine.
"But prevention itself costs money, and some preventive measures can be very expensive, especially if you give them to a lot of people who won't benefit." If preventive care could be provided only to those who are going to get the illness, it would be more cost-effective. "But in the real world, the number needed to screen or to treat in order to prevent one case of illness can be huge," said BU's Frakt, who blogs at theincidentaleconomist.com. Currently, many people who do not benefit from a preventive service receive it, paying something for nothing. Studies have calculated those numbers, which can be surprisingly high.
For instance, 217 high-risk smokers would have to undergo a CT lung scan for one to be spared death from lung cancer, according to a database of studies maintained by Dr. David Newman, an emergency physician at Mount Sinai School of Medicine in New York City. One hundred post-menopausal women who have had a bone fracture would have to take drugs called bisphosphonates in order for one to avoid a hip fracture. By comparison, only 50 people with heart disease must be treated with aspirin for one to avoid a heart attack or stroke, making this a good buy.
The numbers of people who need to be treated for one to benefit are so high because so few will get the disease the preventive is meant to avert. It's like treating every house for termites, said Neumann, co-author of the Robert Wood Johnson report: The vast majority would never have gotten infested in the first place, so the thousands spent to avoid the infestation is money for nothing. The failure of many preventive services to improve health, plus the large number of people who have to receive preventive care for one to be spared an illness he or she would otherwise get, limit the economic savings.
A better gauge of the value of preventive medicine is bang for the buck; that is, not whether it reduces healthcare spending but whether it buys more health than treating the disease does. "We don't ask whether cancer treatment or heart disease treatment saves money," said Dr. Steven Woolf, professor of family medicine at Virginia Commonwealth University Medical Center in Richmond. "But it is reasonable to ask how to make our healthcare dollar go further." On that score, screening for hypertension and for some cancers (such as colorectal and breast) are good investments, he said, at less than $25,000 per year of healthy life. In contrast, such common treatments as angioplasty cost $100,000 or more per healthy year of life.
There are two glimmers of hope in this bleak picture. For preventive medicine to help rein in the nation's soaring healthcare spending, it should be provided someplace other than doctors' offices. "Some of the most common chronic, preventable diseases might be best addressed outside the clinical setting," said the Trust's Levi, such as through wellness programs at YMCAs and health education and screening programs at houses of worship. "But that requires Medicaid to be more flexible in who they'll reimburse." It also requires a more expansive definition of preventive medicine.
The Trust suggests such steps as extending bus lines to parks so people without cars can go someplace pleasant for physical activity and other "community-based" efforts. These strategies save more money in healthcare spending than they cost. For instance, at a program in Akron, Ohio, profiled in the new report, physicians and others coordinate care for patients with Type 2 diabetes. It reduced the average cost of care by more than 10 percent, or $3,185 per year, largely by reducing pricey emergency-room visits.
And at Boston Children's Hospital, an asthma program that sends community health workers into patients' homes to reduce the environmental triggers of asthma has saved $1.46 in healthcare costs for every $1 invested. It has reduced asthma-related hospital admissions by 80 percent and asthma-related emergency department visits by 60 percent, reports the Trust.
The other promising approach is to target preventive care at those most likely to develop a chronic disease, not at low-risk people. Such "smart" prevention increases the chances of preventing expensive diseases and saving money. In contrast, unthinking expansion of preventive medicine is the wrong prescription, say experts. "If you start giving preventive care to more people, many of whom won't benefit from it, it's going to be very, very expensive," said Tufts' Neumann.
Thursday, December 6, 2012
Men more prone to cancer: Vic study
VICTORIAN men are more likely to
suffer cancers linked to smoking and drinking such as lung and liver
cancer than women, according a new study.
Not only were more men diagnosed with any cancer in 2011, but they
were also more likely to lose their battle with cancer than women, the
Cancer Council Victoria study shows.
The study, released on
Friday, is a reminder for men to cut their cancer risk, with the
difference put down to the historical prevalence of cancer risk factors
such as smoking and alcohol consumption among men, said Cancer Council
chief Todd Harper.
"Some research also suggests that men tend to
present when their cancer is at a later stage, which may be a factor in
differing survival rates," Mr Harper said in a statement.
The study revealed just over half of the 28,405 Victorians diagnosed with cancer last year were men.
Men were also over-represented in the number of cancer deaths, with
5921 Victorian men losing their battle with cancer compared with 4,710
women.
The study found more men were likely to be diagnosed with
cancers associated with smoking and alcohol such as lung, bladder and
stomach cancer, oral cavity cancers, and cancers of the oesophagus,
larynx and liver.
Mr Harper urged Victorian men to be aware of any bodily changes and get regular checks and screenings.
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