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Critique hits hospital reports

Posted on: Tuesday, 15 March 2005, 09:00 CST

Critique hits hospital reports

CHICAGO - The trend toward issuing "report cards" on the nation's hospitals and doctors has not been shown to improve care, and might even harm patients, some physicians warn.

In a critique published in the Journal of the American Medical Association, two doctors cite a 1997 survey that found many surgeons reject some sicker patients for fear of hurting their report card grades.

Medicare began requiring hospitals to report data on 10 quality measures last year, and posts the information on the Internet. It now plans to start rewarding better-performing hospitals and doctors with more money.

"I don't want to come across as being against quality improvement, but we need more empirical evidence before we launch the universal projects that people are talking about," said Dr. Rachel Werner of the Philadelphia Veterans Affairs Medical Center, who wrote the critique with colleague Dr. David Asch.

After New York state started reporting doctors' patient death rates, those death rates dropped. But in the 1997 survey of 104 heart surgeons, two-thirds said they had selected healthier patients for surgery and rejected sicker patients to keep their scores high, Werner and Asch said.

On the Net:

Medicare reporting site: cms.hhs.gov/quality/ hospital

JAMA: jama.com

Vaccinations late, CDC study finds

CHICAGO - While overall U.S. immunization rates are high, many toddlers get their recommended shots several months or more late - delays that have probably contributed to some illnesses and deaths, a government study suggests.

By age 2, 37 percent of youngsters got at least one recommended vaccination more than six months late, researchers from the Centers for Disease Control and Prevention found. About 20 percent of children had similar delays for four or more vaccinations.

Cancer risk feared in eczema drugs

WASHINGTON - The Food and Drug Administration issued an advisory to doctors urging caution in prescribing two drugs for eczema, because of the possibility of cancer.

Elidel and Protopic will get new label warnings pointing out that an increased risk of cancer may be associated with their use, the agency said. They are applied to the skin to control eczema by suppressing the immune system.

37 Oregonians pick suicide in '04

PORTLAND, Ore. - Thirty-seven terminally ill people killed themselves in 2004 under Oregon's assisted suicide law, down from 42 the year before, state health officials said.

The average age was 64, according to the seventh annual report by the Oregon Department of Human Services. As in the past, most of the patients suffered from cancer.

Oregon is the only state that allows doctor-assisted suicide in which terminally ill people can get a prescription for a lethal dose of drugs.

More dangers in passive smoking

A sweeping new study on the health risks of breathing secondhand smoke adds breast cancer and premature birth to an already long list of ills associated with cigarettes.

The findings go further in establishing the link between cigarettes and breast cancer than any before.

"It's another indictment of tobacco and the health effects of secondhand smoke on healthy people, especially children," said Paul Knepprath, vice president for government relations with the American Lung Association of California.

The newest, most attention-getting finding is that exposure to secondhand smoke may increase a woman's risk of breast cancer nearly twofold, and that exposure to secondhand smoke raises by 50 percent to 80 percent the risk of premature birth.

Source: Commercial Appeal, The

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