all health care policy stories

Decline in cigarette smoking in U.S. significantly offset by increase in other tobacco products

404132862 — Wed, 11 Jun 2008 09:35:54 -0400

While trends in cigarette smoking and sales have declined in the U.S. for the past decade, sales of non-cigarette tobacco products have been on the rise. Researchers from the Harvard School of Public Health, led by Professor Greg Connolly, director of the Tobacco Control Research Program at HSPH, and Hillel Alpert, research associate in the program, sought to compare trends in sales of all tobacco products in the U.S. and found that 30% of the recent decline in cigarette sales may be offset by the robust sale of small cigars, snuff and roll-your-own products. Thus, the apparent magnitude of overall decline in tobacco use in the U.S.

NIH awards Harvard Medical School $117.5 million, five-year grant for patient-centered research

404132862 — Thu, 29 May 2008 12:42:32 -0400

The National Institutes of Health today announced that Harvard Medical School (HMS) will receive $117.5 million over the next five years for the establishment of a Clinical and Translational Science Center (CTSC) that will transform patient-oriented, laboratory-to-bedside research at HMS and its affiliated hospitals.

Life expectancy stagnating, worsening, for large segment of U.S. population

yvette — Wed, 16 Apr 2008 16:20:41 -0400

A new, long-term study of mortality trends in U.S. counties from 1960 to 2000 finds that an overall average life expectancy increase of 6.5 years for men and women is not reaching many parts of the country. Instead, the life expectancy of a significant segment of the population is actually declining or at best stagnating.

Researchers at the Harvard School of Public Health (HSPH) and the University of Washington found that 4% of the male population and 19% of the female population experienced either decline or stagnation in mortality beginning in the 1980s.

Dramatic increase in ER waiting time for seriously ill patients

404132862 — Tue, 15 Jan 2008 12:21:19 -0500

Patients of all racial, ethnic, and socioeconomic status are facing ever-increasing waits for care in emergency rooms, according to a study published online today by the journal Health Affairs. The problem is particularly acute for those who are severely ill, Harvard Medical School researchers at Cambridge Health Alliance found.

Symposium addresses disparities in Native American health care

404132862 — Fri, 09 Nov 2007 20:46:01 -0500

Sunshine Dwojak, a fourth-year Harvard Medical School student, was 26 when her mother died of heart disease, leaving behind three children. Dwojak’s mother was 48.

“My grandmother said our family ‘just wasn’t lucky,’ and my aunt said that ‘longevity doesn’t run in our family,’” Dwojak said. Growing up, she saw many of her family members suffer from mental illness, heart disease, diabetes, and substance abuse.

Almost two million veterans lack health coverage

404132862 — Tue, 30 Oct 2007 17:07:45 -0400

One in every eight (12.2 percent) of the 47 million Americans without health insurance is a veteran or member of a veteran's household, according to a study by Harvard Medical School researchers based at the Cambridge Health Alliance.

Economic motivation could underlie some ordering of imaging tests

404132862 — Sun, 28 Oct 2007 17:44:40 -0400

A new study by researchers at Institute for Technology Assessment in Massachusetts General Hospital's (MGH) Department of Radiology finds that physicians who consistently refer patients to themselves or members of their own specialty for imaging studies, rather than to radiologists, are more likely to order such studies for a variety of medical conditions. The results suggest that economic motivation could underlie some of the excess referrals.

Medical schools' departments, department heads often have industry relationships

404132862 — Tue, 16 Oct 2007 21:18:37 -0400

BOSTON – A study led by members of the Massachusetts General Hospital Institute for Health Policy (MGH-IHP) has found that institutional academic-industry relationships – financial relationships companies have with medical schools or teaching hospitals rather than with individual physicians or scientists – are as common and pervasive as individual relationships. Their report, the first nationwide look at the extent and impact of these relationships, appears in the Oct. 17 issue of the Journal of the American Medical Association.

Brugge, colleagues urge Senate to increase NIH funding

50443248 — Tue, 02 Oct 2007 16:37:36 -0400

Testifying Monday afternoon (March 19) before a U.S. Senate committee hearing on National Institutes of Health (NIH) funding, Harvard Medical School Cell Biology Department Chair Joan S. Brugge warned that "four years of flat [NIH] funding have had a devastating impact on the trajectory of cancer research," threatening "the rapid progress in developing effective and less toxic treatments for the myriad different cancers."

High-deductible health plans are linked to fewer ER visits

Wed, 11 Jul 2007 09:31:12 -0400

Patients who switched to high-deductible health plans went to the emergency department 10 percent less than patients who remained in traditional plans, according to a new study by the Department of Ambulatory Care and Prevention (of Harvard Medical School and Harvard Pilgrim Health Care). The study, published in the March 14 Journal of the American Medical Association, shows that most of this reduction was for less severe conditions like colds, nausea, and headaches. The authors followed members for approximately one year after the switch to the high-deductible plan.

"Our study showed that for most members, the high-deductible plan seemed to work as intended," said Frank Wharam, research fellow in the Department of Ambulatory Care and Prevention and the study's lead author. "Patients went to the emergency room less frequently for nonemergency conditions."

However, the authors stress that more research is needed to determine long-term health consequences and the impact on different segments of the population. "It will be important to determine how the health of low-income and chronically ill patients is affected," said Wharam. "Our study could not provide conclusive answers. Ideally, high-deductible plans will be structured so that all patients readily seek care when they think they have an emergency."

High-deductible health plans are playing a central role in Massachusetts health insurance reform efforts. Nationwide, they have become increasingly popular as a way to stem rising health care costs and make insurance more affordable to individuals and employers. Monthly premiums are lower than traditional health insurance plans but enrollees must pay for most medical services up to a deductible amount that averages $1,000 to $4,000 per year. Emergency department visits and hospitalizations are often subject to the deductible.

This work was supported by the Harvard Pilgrim Health Care Foundation.

HSPH study suggests taking wraps off drug safety data

Wed, 11 Jul 2007 09:51:14 -0400

For years, pharmaceutical companies have sought to restrict public access to drug safety data collected in clinical trials on the basis that it is proprietary information, arguing that competitors could use that information in the development of their own products. However, a number of recent cases of drugs found to have dangerous side effects after coming to market, such as the anti-inflammatory drug rofecoxib (Vioxx), have raised concerns about safety data being treated as confidential.

Web quiz helps predict women's health

Wed, 11 Jul 2007 11:02:32 -0400

Using data collected from more than 24,000 initially healthy American women, researchers from Brigham and Women's Hospital (BWH) have devised a new Web-based formula called the Reynolds Risk Score that for the first time more accurately predicts risk of heart attack or stroke among women. In addition to usual risk factors like cholesterol, blood pressure, and smoking, the new Reynolds Risk Score adds information on two new factors: family history of heart attack prior to age 60 and blood level of C-reactive protein (CRP), a measure of artery inflammation. Using the new risk assessment tool, the researchers found that nearly 50 percent of women in the study who were estimated to be at "intermediate risk" for heart attack or stroke based on current guidelines were in fact at significantly higher or lower risk levels.

For the 10 million American women currently classified at "intermediate risk," use of the Reynolds Risk Score provides doctors and their patients a much clearer picture of who should or should not receive drug therapies such as statins or aspirin, and highlights the critical impact that can be made on heart disease prevention by diet, exercise, and smoking cessation. The findings appear in the Feb. 14 issue of the Journal of the American Medical Association and are available in a user-friendly format for both physicians and their patients at http://www.reynoldsriskscore.org.

"Women as well as men suffer premature heart attacks and stroke, but our standard methods for risk prediction have not been as effective in preventing disease among women," said cardiologist Paul Ridker, the Eugene Braunwald Professor of Medicine at Harvard Medical School, who is director of the Center for Cardiovascular Disease Prevention at BWH and lead author of the study. "One of the problems cardiologists and preventive physicians face is that we often underestimate women's risk for heart disease and stroke. With the new Reynolds Risk Score, we found many women to be at substantially higher risk than anticipated. That's an enormous opportunity for prevention because if physicians can accurately tell a woman in her 30s or 40s about true lifetime risk, they've got a much better chance of motivating her to stop smoking, get regular exercise, reduce her blood pressure, and where indicated, start a statin or aspirin regimen."

In addition to providing each woman with an estimate of her risk of suffering a future heart attack, stroke, or other major cardiovascular event over the next 10 years, the Reynolds Risk Score Web site simultaneously shows each woman what her risk would be if she improved each of her individual risk factors to optimal levels. For young women, risk may appear low over the next 10 years, yet can be very high over a lifetime. The Reynolds Risk Score also allows each woman to calculate risk as she ages, demonstrating the impact that risk reduction early in life can have on future events. The Reynolds Risk Score Web site provides useful links to prevention programs for women from the National Heart, Lung and Blood Institute, the American Heart Association, and the American College of Cardiology.

U.S. lagging in adoption of electronic health records

Thu, 12 Jul 2007 10:43:04 -0400

With fewer than one in 10 doctors making full use of electronic health records and as few as 5 percent of hospitals using one form of them, the U.S. health care industry is way behind in adopting new systems that can improve patient care and reduce medical mistakes, according to a new report co-authored by Harvard researchers.

"We are pitifully behind where we should be. We must find ways to get more physicians to embrace this technology if we are to make major strides in improving health care quality," said study co-author David Blumenthal, the Samuel O. Thier Professor of Medicine, professor of health care policy, and director of Massachusetts General Hospital's Institute for Health Policy.

Health care institutions have long adopted computerized records for financial and administrative systems, but have been slower to adopt electronic health records for the clinical side of their operations even though those systems have the potential to reduce medication mistakes, unnecessary tests, and inappropriate care; to cut costs; and to improve patient monitoring.

President George W. Bush has called on U.S. health care institutions to adopt electronic systems for a majority of patients by 2014 as a way to make health care delivery more efficient and more effective.

The report, "Health Information Technology in the United States: The Information Base for Progress," was drafted by a team of researchers from Harvard-affiliated Massachusetts General Hospital, the Harvard School of Public Health, and George Washington University. It was sponsored by the Robert Wood Johnson Foundation and the federal government's National Coordinator for Health Information Technology.

Interns continue to work overly long shifts, study finds

Thu, 12 Jul 2007 12:12:17 -0400

That intern working on you at the hospital may be so sleep-deprived his or her performance is no better than that of a drunk. That's one conclusion of a national study by investigators at the Harvard Medical School.

Earlier surveys of a variety of medical centers found that sleepy doctors-in-training endanger both patients and themselves. To cut off federal attempts to solve this serious problem by legislation, the Accreditation Council for Graduate Medical Education, in 2003, put a cap on hours that residents and interns training to be medical doctors can work. (Interns are those in their first year of training.) The rules limited shifts to a maximum of 30 consecutive hours and no more than 80 hours a week. In addition, residents and interns must have one day off in every seven.

'Virginity pledges' by adolescents may bias their reports of premarital sex

70652986 — Mon, 26 Mar 2007 06:27:15 -0400

Adolescents who sign a "virginity pledge" and then go on to have premarital sex are likely to disavow having signed such a pledge, according to an analysis of survey data by Harvard School of Public Health researcher Janet Rosenbaum published in the advance online edition of the American Journal of Public Health's June 2006 issue.

Conversely, adolescents who have had premarital sex and then decide to make a virginity pledge are likely to misreport their earlier sexual history.