Thursday, March 22, 2018

Does Medical Expansion Improve Population Health?

Does Medical Expansion Improve Population Health?

Hui Zheng, Linda K. George

First Published February 1, 2018


Medical expansion has become a prominent dynamic in today’s societies as the biomedical model becomes increasingly dominant in the explanation of health, illness, and other human problems and behavior. Medical expansion is multidimensional and represented by expansions in three major components of the healthcare system: increasing medical investment, medical professionalization/specialization, and the relative size of the pharmaceutical industry. Using Organisation for Economic Co-operation and Development health data and World Development Indicators 1981 to 2007, we find medical investment and medical professionalization/specialization significantly improve all three measures of life expectancy and decrease mortality rate even after controlling for endogeneity problems. In contrast, an expanded pharmaceutical industry is negatively associated with female life expectancy at age 65 and positively associated with the all-cause mortality rate. It further compromises the beneficial effect of medical professionalization/specialization on population health. In general, medical professionalization/specialization and gross domestic product per capita have similar and stronger effects than medical investment.

Panelists discussed low-value care, unnecessary services, and what can be done to address overuse in healthcare during a panel at the University of Michigan Center for Value-Based Insurance Design’s (V-BID) annual V-BID Summit on March 14.

Doctors in Singapore have been warned that they will face action from the body that regulates them, as well as the Ministry of Health (MOH), if they overcharge patients or put them through superfluous treatments.

The process to create a list of essential diagnostics— similar to the list of essential medicines that are price controlled by the government—kicked off last week, spearheaded by the Indian Council of Medical Research (ICMR), with support of the WHO.

Avoiding Unnecessary Surgery and Radiation in Low-Risk DCIS

Warning over 'unnecessary' hospital admissions for terminally ill patients

Sunday, March 4, 2018

Heart attack patients prescribed antidepressants have lower one-year survival rates, according to research presented today at Acute Cardiovascular Care 2018, a European Society of Cardiology congress.

After adjusting for baseline characteristics the researchers found that the rates of stroke and subsequent heart attacks were similar between the two groups, but patients prescribed antidepressants had significantly worse survival. The rate of all-cause mortality at one-year after discharge was 7.4% in patients prescribed antidepressants compared to 3.4% for those not prescribed antidepressants ( P value less than 0.001).

Antidepressant prescription was an independent predictor for mortality, and increased the odds by 66% (odds ratio: 1.66; 95% confidence interval: 1.16 to 2.39).

"This was an observational study so we cannot conclude that antidepressants caused the higher death rate," noted Ms Fehr.

She concluded: "Our study showed that many patients are treated with antidepressants after a heart attack. More research is needed to pinpoint the causes and underlying pathological mechanisms for the higher mortality we observed in this patient group."

More than 80% of breast cancer screening MRIs conducted between 2007 and 2014 occurred in women who did not meet the professional guidelines for these screenings, according to findings recently published in the Journal of General Internal Medicine.