News Briefs
December 1, 1999 4 minutes read
News Briefs
Elderly heart patients fare slightly better with HMOs
Elderly heart attack patients in Minnesota who were covered by HMOs received life-saving thrombolytic treatments at least as often as those covered by fee-for-service (FFS) plans. They were also slightly more likely to have received emergency transportation and aspirin therapy, according to a study funded by the Agency for Health Care Policy and Research (AHCPR) and published in the Sept. 27 Archives of Internal Medicine.
In the study, researchers from Harvard Medical School and Harvard Pilgrim Health Care reviewed the medical records of 2,304 elderly Medicare patients admitted with acute myocardial infarction (AMI) to 20 hospitals in Minnesota from October 1992 through July 1993, and from July 1995 through April 1996.
They found that the speed with which patients received care and the quality of that care were of equal or slightly higher quality under HMO coverage vs. FFS coverage.
Researchers also looked at other dimensions of care for persons with AMI, including their use of emergency transportation and whether they received aspirin therapy in addition to thrombolytic medication. Patients with HMO coverage were slightly more likely to have used an ambulance to get to the hospital.
The researchers attributed this to HMOs’ around-the-clock telephone triage systems that encourage patients with acute symptoms to use emergency transportation. Patients with HMO coverage also were slightly more likely to have received aspirin therapy, which researchers believe is because HMOs employ a larger percentage of younger physicians who may be more aware of newer drug treatments.
(For more information see: Timeliness and quality of care for elderly patients with acute myocardial infarction under health maintenance organization vs. fee-for-service insurance. Arch Intern Medicine 1999; 159:2,013-2,020.)
Patients, docs want to increase use of e-mail
Although 40% of general medicine clinic patients regularly use e-mail, only 14% of them have used it to communicate with their doctors, a recent survey by researchers at the University of Michigan Health System has found. But five times that number want to do so.
The survey of 320 patients and 75 resident physicians was conducted at the outset of a larger study at the University of Michigan and the Ann Arbor Veterans Affairs Hospital, which will now evaluate a specially designed e-mail system that facilitates electronic communication between patients and physicians.
While a relatively low percentage of the study’s patients reported using e-mail to communicate with their doctors, some 70% of them (both e-mail users and nonusers) said they would indeed like to communicate with their health care provider via e-mail, according to researchers. In addition, 83% of the patients’ physicians said they thought e-mail was a good way to answer patients’ non-urgent medical questions, even though only 27% said they were currently using e-mail to communicate with patients. These results suggest that there is great opportunity to facilitate electronic communication between patients and their doctors.
The preliminary survey was conducted to determine baseline e-mail use patterns and attitudes toward the use of e-mail. It served as a prelude to a larger study now under way on the usage and operational impacts of EMAIL (Electronic Messaging, Advice, and Information Link), a U-M General Medicine Clinic system that allows patients to communicate with their doctors through an electronic triage system about such things as appointment times, referrals, prescription renewals, or general health questions.
For more information on the EMAIL study, contact the Consortium for Health Outcomes, Innovation, and Cost Effectiveness Studies (CHOICES) at the University of Michigan at (734) 647-8094, e-mail: [email protected], or visit the CHOICES Web site at http://www.med. umich.edu/choices.
Emergency info form aids special needs children
A new medical information form will help ensure that children with chronic diseases or disabilities get appropriate care in emergencies.
Jointly designed by the American College of Emergency Physicians (ACEP) and the American Academy of Pediatrics (AAP), the Emergency Information Form (EIF) "is a tool that will help facilitate the transfer of relevant information for children with special health care needs," according to a statement from ACEP.
Physicians often find themselves treating an acutely ill or injured child with a significant past medical history without the benefit of accurate and relevant information, according to the statement. "The adults accompanying the child may recall some important data, but they are usually unable to provide the critical information sought by the emergency physician, intensivist, paramedic, nurses, etc."
Additionally, children may become ill or injured when they are in the company of adults familiar with their history. "In both of these situations," according to ACEP, "a succinct and accurate health summary is needed to give the health care professionals relevant and critical information."
The two-page EIF is designed to help remedy that situation. Containing fields for patient and physician identification, diagnoses/past procedures/physical exam, clinical management data, and immunization history, the EIF is filled out (well in advance of emergencies) by a child’s primary physician and parents.
ACEP recommends copies be kept at the home and parental workplaces, as well as on file in the offices of the child’s primary and specialty physicians and at emergency departments where the child is most likely to present in an emergency. Ideally, an EIF should also be on file with a central repository, such as the MedicAlert Foundation.
Blank EIF’s can be downloaded from the AAP (www.aap.org) and ACEP (www.acep.org) Web sites. Copy-ready forms were published in the October issues of ACEP’s Annals of Internal Medicine and the AAP’s Pediatrics. They are also available for purchase at a nominal cost in packets of 100 from AAP.
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