Study: CRNAs offer same level of care
A study published in the August issue of Health Affairs suggests that there are no differences in patient outcomes when anesthesia services are provided by certified registered nurse anesthetists (CRNAs), physician anesthesiologists, or supervised by physicians, according to the American Association of Nurse Anesthetists (AANA) in Park Ridge, IL.
The national study, titled "No Harm Found When Nurse Anesthetists Work Without Supervision by Physicians," was conducted by RTI International.
The study examined nearly 500,000 individual cases and confirms what previous studies have shown: CRNAs provide safe, high-quality care, according to AANA. The study also shows the quality of care administered is equal, regardless of supervision.
Currently, the Centers for Medicare & Medicaid Services (CMS) prohibits Medicare payments to hospitals and ambulatory surgery centers when CRNAs provide anesthesia care in the absence of physician supervision. However, starting in 2001, CMS began allowing states to opt-out of the Medicare physician supervision requirements for CRNAs.
Since then, 15 states most recently California in 2009 have chosen to opt out.
The study compared patient outcomes in states where the supervision requirement is in place with patient outcomes in the 14 states that had opted out of the requirement between 2001 and 2005. The research found that patient outcomes did not differ.
"We find no evidence that opting out of the oversight requirement harms patients in any way," said study author Jerry Cromwell, PhD.
People turning to online health info
The latest Harris Poll, measuring how many people use the Internet to look for information about health topics, finds that the numbers continue to increase.
Harris Interactive said that the poll first used the work "cyberchondriacs" to describe such individuals in 1998, when just over 50 million American adults had gone online to look for health information. By 2005, that number had risen to 117 million.
In the new poll, which released results in early August, the number of so-called "cyberchondriacs" had jumped to 175 million from 154 million in 2009. Also, the frequency of usage has increased.
Thirty-two percent of all adults who are online say they look for health information "often," compared to 22% last year.
Other findings in the latest Harris Poll include:
- While the percentage of adults who go online (79%) has not changed significantly for several years, the proportion of those who are online and have ever used the Internet to look for health information has increased to 88% this year the highest number ever.
- Fully 81% of all cyberchondriacs have looked for health information online in the last month. And 17% have gone online to look for health information 10 or more times in the last month. On average, cyberchondriacs do this about six times a month.
- Very few of such individuals are dissatisfied with their ability to find what they want online. For example, only 8% believe that the information they found was unreliable.
- Just over half (53%) of such individuals report that they have discussed information they found online with their doctors.
Hospital execs and "meaningful use"
In October, hospitals can start to qualify for incentive payments for meaningful use of electronic health records (EHRs).
A new survey by CSC Global Healthcare Group of hospital executives revealed that although meeting the requirements for meaningful use incentives is a high priority, executives are also busy planning for other aspects of health care reform, including changes to payment models.
Of the executives surveyed, 90% report that achieving meaningful use of an inpatient EHR is one of their top two priorities; 67% say it is their highest priority.
Some of the other findings include:
- 66% are planning to participate in a health information exchange (HIE); currently, only 11% participate in a statewide HIE, while 26% have established a private hospital-sponsored HIE.
- When more than 30 million newly insured people enter the health care system in 2014, one-quarter of those surveyed expect their organization will experience a significant strain on capacity to provide care, and an additional 43% expect to experience a slight strain on capacity.
- Hospital executives anticipate the biggest impact will be on outpatient primary care (36%), followed by demand in the emergency department (33%).
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