Friday, March 13, 2009

Health Headlines - March 13

Report Questions Value of U.S. Health Spending

U.S. health spending is too high and delivers too little benefit, according to a report released Thursday by a group called the Business Roundtable, which represents the CEOs of major companies.

The United States spent $2.4 trillion on health care, or $1,928 per person in 2006. That's at least 2.5 times more per person than any other developed country, yet the health of Americans lags behind those nations, said the Associated Press.

The report factored health measures and costs into a 100-point "value" scale and found that the United States is 23 points behind five leading economic competitors: Canada, Japan, Germany, the United Kingdom and France. All those nations have public health coverage for their citizens.

The U.S. lags even further behind (46 points) when compared with emerging economic competitors China, Brazil and India, according to the report.

"Spending more would not be a problem if our health scores were proportionately higher," Dr. Arnold Milstein, one of the authors of the study, told the AP. "But what this study shows is that the U.S. is not getting higher levels of health and quality of care."


Former NYC Health Chief Likely to Be Named as FDA Leader

Dr. Margaret A. Hamburg, a former New York City health commissioner, is likely to be nominated this week as President Barack Obama's choice to lead the U.S. Food and Drug Administration, The New York Times reports.

Hamburg, 53, would succeed Dr. Andrew C. von Eschenbach, who led the agency from 2005 until last January. The Obama administration was also expected to name Baltimore's health commissioner, Dr. Joshua Sharfstein, as Hamburg's chief deputy. Sharfstein led Obama's transition team for the FDA, the Times said.

Hamburg was appointed by former Mayor David N. Dinkins as acting city health commissioner in 1991 and became commissioner the following year. When former Mayor Rudolph Giuliani took office in 1994, she was asked to stay on the job. Under Hamburg's lead, a tuberculosis control program produced sharp declines in the incidence of the disease in New York, and child immunizations also rose, the paper reported.

Hamburg's selection was first reported Wednesday on the The Wall Street Journal's Web site, the Times said. "Peggy has a deep commitment to the public health and, while she appreciates the vital role of industry, will surely focus on what is best for the public," Dr. Harvey V. Fineberg, president of the Institute of Medicine, the medical arm of the National Academy of Sciences, told the Times.


Doctor May Have Faked Data in Many Studies

A highly influential Massachusetts anesthesiologist may have fabricated results in at least 21 published studies, according to officials at Baystate Medical Center in Springfield.

Dr. Scott S. Reuben has published dozens of studies on the use of more than one type of drug to relieve post-surgical pain and speed recovery. This method, multimodal analgesia, is an important and emerging field of anesthesiology, the Boston Globe reported.

Last year, hospital officials launched an investigation of Reuben's work and identified 21 published papers over 13 years in which all or some of the data were fabricated. In many cases, "there was no clinical trial, because there were no patients," said Dr. Hal Jenson, Baystate's chief academic officer.

Several medical journals were notified about the investigation results, and they are in the process of retracting Reuben's papers, Jenson told the Globe.

If proven true, this may be among the largest and longest-running medical fraud cases, according to experts.

"This would be the largest research fraud in anesthesia," said Dr. Steven Shafer, editor of the journal Anesthesia & Analgesia.

"Doctors have been using [his] findings very widely. His findings had a huge impact on the field. The act of fabricating data is so difficult for me to comprehend. It's beyond my ability to imagine," Shafer told the Globe.


Health Surveys May Be Skewed by Excluding Cell Phones

More than one in six American homes -- 17.5 percent of them -- had only wireless phones as of a year ago and that could be skewing telephone survey results for everything from political polls to product marketing and health surveys, the Associated Press reported Wednesday.

Major survey organizations, including the U.S. Centers for Disease Control and Prevention's National Health Interview Survey (NHIS), do not include wireless numbers when they conduct random-digit telephone surveys. In a 2007 survey using Census updates, the CDC found that cell-only households varied widely by state, sometimes within regions and between neighboring states, according to Stephen Blumberg, a senior scientist at the CDC's National Center for Health Statistics.

"We would expect that today, in 2009, the prevalence rates in every state have increased, perhaps by 5 percentage points or more. What we don't know is whether the rate of growth is the same in every state," Blumberg told the AP in an interview. The issue is important, because the NHIS updates and releases estimates for 15 key adult health indicators every three months, according to a CDC news release issued Wednesday about cell phone usage in the United States.

Blumberg told the AP that health surveys omitting cell-only respondents could, among other things, underestimate not only the number of smokers and binge drinkers, but also those who exercise regularly.

Oklahoma and Utah -- at 26 percent -- lead the country in going wireless, according to federal estimates released Wednesday, and that rate was at least 20 percent in nine other states Nebraska, Arkansas, Idaho, Iowa, Kentucky, New Mexico, Texas, South Carolina and Tennessee and the District of Columbia., the AP reported.

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