A new Dartmouth-led study reveals how ACOs are using home visits to improve care management and identify patient needs while reducing hospital use. The majority of ACOs reported using home visits within 72 hours of post-discharge, often conducted by a care management team member.
Advance care planning conversations with hospitalized, older patients are infrequent due to emotional challenges and physician reluctance. Despite training and financial incentives, only a quarter of physicians regularly document ACP conversations, leaving many patients without input on end-of-life care.
A new study by researchers from The Dartmouth Institute found that only a few patient decision aids are available for seriously ill patients near death, and their quality is varying. The tools were designed for specific conditions or life-sustaining treatments but lacked general treatment approaches.
Researchers explore how AI can analyze words and phrases, turn-taking patterns, and tone to improve medical communications. The technology has potential to revolutionize patient care by providing clinicians with assessments of their communication skills at lower costs.
Over two decades, medical marketing in the US has seen a dramatic increase from $17.7 billion to $29.9 billion, with TV and digital advertising driving the largest growth. However, oversight of these activities has remained limited, despite significant spending and promotional efforts by drug companies.
Researchers found that VA hospitals provided the best care and rarely the worst care in local health care markets. The findings suggest that VHA generally provides excellent care, contradicting some recent negative reports.
A new study published in BMJ Open found that healthcare professionals in accountable care organizations have a positive sentiment towards patient engagement and activation, but struggle with understanding and implementing these approaches. The researchers highlight the need for improved training and support to overcome barriers and ach...
A recent national survey of internal medicine doctors found that three-quarters reported financial ties to industry, with drug samples and food/beverage being the most common benefits. The study also revealed significant reductions in certain types of payments compared to a previous survey in 2009.
A study found that 40-50% of leading hip-hop music videos from 2013-2017 contained tobacco and marijuana use, with brand placement increasing with song popularity. The prevalence of combustible or electronic use rose with songs' popularity, particularly among young people.
The Dartmouth Institute has received a $3.5 million grant to test preventative interventions for acute kidney injury (AKI) in patients undergoing cardiac catheterization. The study aims to evaluate the effectiveness of virtual learning collaboratives with and without automated surveillance reporting.
The study found that CPC+ practices primarily served wealthier areas, with lower median incomes and higher uninsured rates. In contrast, Medicare fee-for-service enrollees in areas without a CPC+ practice had significantly higher use of inpatient discharges.
A first-of-kind study by The Dartmouth Institute for Health Policy & Clinical Practice assesses clinician and patient attitudes towards recording clinical visits. The study found that 28% of clinicians reported recording a visit, with oncologists and physical rehabilitation specialists more likely to have done so.
A study found that having friends who are former smokers decreases the odds of quitting smoking, while highly connected friend groups also show promise. Participants reported strong support from their contacts, with 90% approving of using counseling to quit.
Thyroid cancer incidence has tripled in the US over 25 years, with over 50,000 people diagnosed annually. Experts propose measures to reduce overtreatment, such as active surveillance for small papillary thyroid cancers and more conservative surgical approaches like lobectomy.
A study by The Dartmouth Institute found that a federal regulation change from 2013-2017 led to gaps in substance abuse data, affecting prevalence estimates of chronic conditions like hepatitis C and depression. This can result in underestimated rates of co-morbidity, particularly among younger populations.
A new study found per-capita end-of-life care costs have been declining since 2008, with significant contributions from reduced inpatient and physician expenditures. The decline contributed to moderation in growth of overall per-capita Medicare spending.
The use of digital recordings in medical visits holds great promise for improving healthcare outcomes, including enhanced patient engagement, shared decision-making, and education. However, the authors caution that there are pressing need to develop new policies on data collection, management, and storage.
A recent study found that 37% of ACOs have a management partner, who provides essential services such as data analysis, administrative support, and care coordination. These partnerships enable smaller organizations to participate in ACOs and improve quality, with management partners also providing financing and acting as 'ACO-enablers'
A recent study found that changes between interim and final publications of randomized trials can be significant, affecting clinicians' and the public's understanding of treatment benefits. The study analyzed 613 interim publications and compared them with their final versions.
Restasis, approved by FDA in 2003, shows no direct improvement in symptoms but is marketed as treatment for chronic dry eye disease. The drug's extensive marketing campaign created a perceived need, driving $8.8 billion in US sales between 2009 and 2015.
A recent study examined the intubation decision-making process of 73 hospital-based doctors from three academic medical centers. The researchers found that mental models of doctors who deviated from patient preferences focused on reversibility, inferred consent, and comfort levels. This variation highlights the need for well-structured...
Researchers at The Dartmouth Institute found that physicians with more experience and certain specialties tend to slow the use of carotid revascularization procedures. Despite evidence showing these procedures don't benefit older or symptom-free patients, decline rates remained inconsistent across specialties.
The study highlights four reasons for the failure of ACOs to achieve savings: economic barriers such as weak incentives and lack of patients, and organizational challenges like knowledge development needs and complexity. The authors recommend a flexible approach to motivating providers.
Patient recordings of doctor's visits are becoming more common, but laws governing them vary by state. In states with 'one-party' consent rules, patients can record clinical encounters without the doctor's permission, while in 'all-party' jurisdictions, covert recordings are illegal unless all parties consent.
A study published in the New England Journal of Medicine found that wealthier individuals are more likely to receive cancer diagnoses due to increased testing. However, mortality rates from these cancers have been decreasing, largely due to improved treatments. The authors suggest alternative payment models and reduced financial confli...
Patients with thyroid cancer who choose not to intervene report feeling isolated and anxious, despite lack of support from healthcare providers. Many keep diagnosis a secret to avoid negative feedback, but only a few find satisfactory support from others.
A Dartmouth Institute study found that regions with high specialist to primary care ratios have more overuse of low-value services, and the use of these services remained relatively consistent over time. The study also highlighted a concerning 'potential for double jeopardy in health services receipt among black Americans'.
A new study by The Dartmouth Institute finds that Accountable Care Organizations (ACOs) with a high proportion of minority patients tend to perform worse on quality-of-care measures. ACOs serving these populations often struggle to offer essential services like routine specialty care and palliative care.
According to a new Dartmouth Institute study, 16 of 32 ACOs addressed patients' nonmedical needs. ACOs are creating financial incentives for providers to improve outcomes and lower costs. The study found that addressing these needs can lead to reduced medical costs and improved quality of care.
A Dartmouth Institute-led team is developing a universal electronic medical record (EMR) toolkit to predict hospital readmission risk. The toolkit will integrate with existing EMRs to monitor and measure risk of readmission, focusing on patients at highest risk, particularly those hospitalized for acute myocardial infarction (AMI).
A recent study found that over three-quarters of patients were exposed to at least one non-opiate drug associated with increased fracture risk before their fracture. The researchers suggest that better management of these high-risk drugs may help prevent secondary fragility fractures in the elderly population.
A research team at The Dartmouth Institute is conducting a three-year study to compare care with and without decision aids for women newly diagnosed with early-stage breast cancer. The study aims to show that using decision aids reduces anxiety, decision regret, and improves quality of life for patients.
A new study found that receiving treatment at Primary Stroke Centers (PSCs) led to significantly better survival rates for patients traveling less than 90 minutes. However, the benefit was nullified when travel time exceeded 90 minutes. The study used a cohort of Medicare beneficiaries with acute stroke admitted between 2010 and 2013.
A systematic literature review by The Dartmouth Institute found that multicomponent strategies targeting both patient and clinician involvement are effective in reducing low-value care. These interventions include providing feedback to physicians and medical staff on their use of low-value services.
A new study found that state laws restricting prescription opioids had no measurable effect on opioid use among disabled Medicare beneficiaries. The analysis revealed no significant association between state laws and hazardous prescribing patterns.
A new study by the Dartmouth Institute found that Medicare Accountable Care Organizations (ACOs) are making modest gains in reducing high-cost care settings. For patients with multiple conditions, ACOs saved an estimated $136 per patient annually, while clinically vulnerable patients saw savings of $456 per year.
Researchers compared ClinicalTrials.gov and Drugs@FDA for results reporting accuracy, finding that while Drugs@FDA was useful for primary outcomes, it lacked validity for secondary outcomes and adverse events. Integration between the two sites could lead to better health information.
A new study led by Dartmouth researchers finds that individual placement and support services can lead to competitive employment for people with serious mental illness within 9 months. The cost-effective approach also reduces health service usage over time.
Researchers developed a new method to measure healthcare value transparently, combining quality and cost measures. They found that hospitals' ability to deliver high-quality, low-cost care varied across procedures, with those providing the highest-value care having more beds and beds than those providing the lowest-value care.
Researchers found that women face a range of barriers to physical activity, including physical challenges and psychological concerns, which vary by weight. A new study suggests that a one-size-fits-all approach may not be effective in helping women become more physically active.
A recent study found that 92.2% of physicians believe doctors should control costs, but only 36.9% have a clear understanding of test and procedure costs. Primary care physicians reported greater awareness of the Choosing Wisely campaign, which aims to identify low-value services.
A study by The Dartmouth Institute for Health Policy & Clinical Practice found that large, urban hospitals are more likely to participate in ACOs, which involve managing hospital care to improve quality and lower costs. Teaching hospitals and those with more services also tend to join ACOs.
A nationwide survey of 1,000 Americans seeking depression treatment and 250 clinicians reveals a disconnect between patients' and clinicians' prioritization of information needed for treatment decisions. Patients prioritize cost and insurance information, while clinicians do not always share this priority.
A recent study involving one million patients found that follow-up times for abnormal screening exams were shorter for breast cancer than for colorectal and cervical cancers. The study characterized cancer screening practice variation across seven centers and noted the potential barriers to timely follow-up, including patient inconveni...
Researchers found significant differences in hospital care for children with medical complexity, including variation in intensive care unit days and diagnostic tests. The study highlights the need to identify best practices to improve quality and reduce costs in care for this growing patient population.
A recent study by researchers found that FDA's 'breakthrough' designation significantly increases the percentage of people who rate a drug as effective and believe in its strong evidence. The study suggests that neutral terms with clear explanations may help consumers make more accurate judgments about these drugs.