Safety Tips from the Red Cross
November 24, 2008 – The American Red Cross wants to remind everyone of important safety issues that will help ensure a safe and happy Thanksgiving holiday.
Since Thanksgiving usually involves preparing lots of food, cooking safety should be a priority. Unfortunately, cooking fires are more likely to occur on Thanksgiving Day than any other day of the year according to the National Fire Protection Association.
The Red Cross offers the following tips to prevent home fires this Thanksgiving:
• Monitor your cooking at all times. Unattended cooking is the leading cause of Thanksgiving Day home fires.
• Keep potholders and food wrappers at least three feet away from heat sources while cooking.
• Wear tighter fitting clothing with shorter sleeves when cooking.
• Make sure all stoves and ranges have been turned off when you leave the kitchen, and that ovens are turned off when you leave the house.
• Set timers to keep track of turkeys and other food items that require extended cooking times.
• Turn handles of pots and pans on the stove inward to avoid accidents.
• Follow all manufacturer guidelines regarding the appropriate use of appliances.
• After guests leave, designate a responsible adult to walk around the home, making sure that all candles and smoking materials are extinguished.
Finally, it’s important for every household to make sure to have working smoke alarms. The Red Cross encourages people to install smoke alarms on every level of their house and outside sleeping areas and to test the batteries once a month.
Even with the best preparation and precautions, accidents can happen. Cooking-related burns are a common hazard of the Thanksgiving holiday. For a superficial burn, cool the area by running it under cold water until the heat eases and then loosely cover the burn with a sterile dressing to help prevent infection. A critical burn requires medical attention.
Choking is another threat to a happy holiday dinner. Common causes of choking include talking while eating; eating too fast; and trying to swallow large pieces of poorly chewed food. If you feel as if food may be caught in your throat, never leave the room-stay where others can see you and help if your airway becomes blocked.
To help someone who is choking, remember “FIVE-and-FIVE Can Keep Them Alive.” First, ask the person if they are able to breathe and if you can help. Once you know the person is unable to cough, speak or breathe, have someone call 9-1-1 or your local emergency number.
Lean the person forward and give FIVE sharp back blows between the shoulder blades with the heel of your hand. If the obstruction isn’t dislodged, stand behind the person and give FIVE quick, upward thrusts into the abdomen. Repeat back blows and abdominal thrusts as necessary. If you are alone, you can perform abdominal thrusts on yourself, just as you would on someone else. Thrusts can also be administered by leaning over and pressing your abdomen firmly against an object such as the back of a chair
Tuesday, November 25, 2008
Wednesday, November 19, 2008
Are Disease managment Programs effective or too costly- review of recent research
A review of current peer reviewed research or research presented by professional organizations with peer reviewed journals reveals that Disease Management programs are not cost effective for direct costs without inclusion of indirect costs, societal costs. In addition Programs that are effective are long term, and targeted to selected populations.
In effect Insurance companies who must manage a broad scope of health care costs and over a long period of time may benefit from disease management programs for targeted patients. Firms that are out sourcing these models, will find reactive disease management programs too expensive. But other research indicates that proactive programs for health coaching are on the increase and profitable in 2008.
Nov. 9, 2004 (New Orleans) — Disease management improves survival in patients with congestive heart failure (CHF), especially in those with advanced disease. But the program does not save healthcare utilization or costs, according to results of a late-breaking clinical trial presented here at the American Heart Association 2004 Scientific Sessions.
"Disease management promised a lot but those promises may be empty," lead investigator Autumn Dawn Galbreath, MD, vice chairman for clinical programs in the Department of Medicine at the University of Texas in San Antonio, said when presenting the results at an early morning press conference. The formal results were presented at the meeting by coinvestigator Gregory I. Freeman, MD, from the University of Texas Health Science Center in San Antonio.
The investigators randomized 1,069 community-based patients with CHF to receive disease management or usual care. Average age of the group was 70.9 years. All had systolic heart failure with ejection fractions averaging 35% or echo-confirmed diastolic heart failure. Patients were followed for 18 months, with investigators conducting assessments of clinical status by telephone at six-month intervals.
http://www.medscape.com/viewarticle/582790
October 29, 2008 (Philadelphia, PA) — A heart-failure disease-management program that had cut the risk of hospitalization in a predominantly Hispanic and black population [1] is also cost-effective in that the benefit came at an expected societal cost under $25 000 per quality-adjusted life-year (QALY) gained
In the current analysis, the nurse-led intervention cost an average of $2177 per patient but reduced hospital costs by $2378 per patient; however, "higher costs for outpatient procedures, medications, and home healthcare prevented the intervention from being cost-saving over the 12-month study," according to the authors.
The incremental cost per QALY gained for the intervention program was estimated at $19 691 or $21 470, depending on the quality-of-life instrument used, either the Health Utility Index Mark 3 or EuroQol-5D, respectively, after adjustment for baseline quality-of-life differences between groups.
The estimated net 12-month cost to Medicare associated with implementation of the disease-management program was either $3176 or $3673 per QALY, respectively.
The study's results are consistent with an ongoing Medicare demonstration product, according to Hebert et al, that "found no evidence that [its] nurse-management interventions were cost-saving or cost-neutral.
http://www.medscape.com/viewarticle/582790
The economic effectiveness of disease management programs, which are designed to improve the clinical and economic outcomes for chronically ill individuals, has been evaluated extensively. A literature search was performed with MEDLINE and other published sources for the period covering January 1995 to September 2003. The search was limited to empirical articles that measured the direct economic outcomes for asthma, diabetes, and heart disease management programs. Of the 360 articles and presentations evaluated, only 67 met the selection criteria for meta-analysis, which included 32,041 subjects. Based on the studies included in the research, a meta-analysis provided a statistically significant answer to the question of whether disease management programs are economically effective. The magnitude of the observed average effect size for equally weighted studies was 0.311 (95% CI = 0.272-0.350).
The results suggest that disease management programs are more effective economically with severely ill enrollees and that chronic disease program interventions are most effective when coordinated with the overall level of disease severity.
http://www.citeulike.org/user/waffle168/article/197597
Heart failure (HF) disease management programs have shown impressive reductions in hospitalizations and mortality, but in studies limited to short time frames and high-risk patient populations. Current guidelines thus only recommend disease management targeted to high-risk patients with HF.
METHODS: This study applied a new technique to infer the degree to which clinical trials have targeted patients by risk based on observed rates of hospitalization and death. A Markov model was used to assess the incremental life expectancy and cost of providing disease management for high-risk to low-risk patients. Sensitivity analyses of various long-term scenarios and of reduced effectiveness in low-risk patients were also considered. RESULTS: The incremental cost-effectiveness ratio of extending coverage to all patients was $9700 per life-year gained in the base case. In aggregate, universal coverage almost quadrupled life-years saved as compared to coverage of only the highest quintile of risk. A worst case analysis with simultaneous conservative assumptions yielded an incremental cost-effectiveness ratio of $110,000 per life-year gained. In a probabilistic sensitivity analysis, 99.74% of possible incremental cost-effectiveness ratios were <$50,000 per life-year gained. CONCLUSIONS: Heart failure disease management programs are likely cost-effective in the long-term along the whole spectrum of patient
risk. Health gains could be extended by enrolling a broader group of patients with HF in disease management.
http://www.ncbi.nlm.nih.gov/pubmed/18215605
Here is the video link
http://www.bupafoundation.co.uk/asp/awards/08_awards/health_at_work_award.asp
In effect Insurance companies who must manage a broad scope of health care costs and over a long period of time may benefit from disease management programs for targeted patients. Firms that are out sourcing these models, will find reactive disease management programs too expensive. But other research indicates that proactive programs for health coaching are on the increase and profitable in 2008.
Nov. 9, 2004 (New Orleans) — Disease management improves survival in patients with congestive heart failure (CHF), especially in those with advanced disease. But the program does not save healthcare utilization or costs, according to results of a late-breaking clinical trial presented here at the American Heart Association 2004 Scientific Sessions.
"Disease management promised a lot but those promises may be empty," lead investigator Autumn Dawn Galbreath, MD, vice chairman for clinical programs in the Department of Medicine at the University of Texas in San Antonio, said when presenting the results at an early morning press conference. The formal results were presented at the meeting by coinvestigator Gregory I. Freeman, MD, from the University of Texas Health Science Center in San Antonio.
The investigators randomized 1,069 community-based patients with CHF to receive disease management or usual care. Average age of the group was 70.9 years. All had systolic heart failure with ejection fractions averaging 35% or echo-confirmed diastolic heart failure. Patients were followed for 18 months, with investigators conducting assessments of clinical status by telephone at six-month intervals.
http://www.medscape.com/viewarticle/582790
October 29, 2008 (Philadelphia, PA) — A heart-failure disease-management program that had cut the risk of hospitalization in a predominantly Hispanic and black population [1] is also cost-effective in that the benefit came at an expected societal cost under $25 000 per quality-adjusted life-year (QALY) gained
In the current analysis, the nurse-led intervention cost an average of $2177 per patient but reduced hospital costs by $2378 per patient; however, "higher costs for outpatient procedures, medications, and home healthcare prevented the intervention from being cost-saving over the 12-month study," according to the authors.
The incremental cost per QALY gained for the intervention program was estimated at $19 691 or $21 470, depending on the quality-of-life instrument used, either the Health Utility Index Mark 3 or EuroQol-5D, respectively, after adjustment for baseline quality-of-life differences between groups.
The estimated net 12-month cost to Medicare associated with implementation of the disease-management program was either $3176 or $3673 per QALY, respectively.
The study's results are consistent with an ongoing Medicare demonstration product, according to Hebert et al, that "found no evidence that [its] nurse-management interventions were cost-saving or cost-neutral.
http://www.medscape.com/viewarticle/582790
The economic effectiveness of disease management programs, which are designed to improve the clinical and economic outcomes for chronically ill individuals, has been evaluated extensively. A literature search was performed with MEDLINE and other published sources for the period covering January 1995 to September 2003. The search was limited to empirical articles that measured the direct economic outcomes for asthma, diabetes, and heart disease management programs. Of the 360 articles and presentations evaluated, only 67 met the selection criteria for meta-analysis, which included 32,041 subjects. Based on the studies included in the research, a meta-analysis provided a statistically significant answer to the question of whether disease management programs are economically effective. The magnitude of the observed average effect size for equally weighted studies was 0.311 (95% CI = 0.272-0.350).
The results suggest that disease management programs are more effective economically with severely ill enrollees and that chronic disease program interventions are most effective when coordinated with the overall level of disease severity.
http://www.citeulike.org/user/waffle168/article/197597
Heart failure (HF) disease management programs have shown impressive reductions in hospitalizations and mortality, but in studies limited to short time frames and high-risk patient populations. Current guidelines thus only recommend disease management targeted to high-risk patients with HF.
METHODS: This study applied a new technique to infer the degree to which clinical trials have targeted patients by risk based on observed rates of hospitalization and death. A Markov model was used to assess the incremental life expectancy and cost of providing disease management for high-risk to low-risk patients. Sensitivity analyses of various long-term scenarios and of reduced effectiveness in low-risk patients were also considered. RESULTS: The incremental cost-effectiveness ratio of extending coverage to all patients was $9700 per life-year gained in the base case. In aggregate, universal coverage almost quadrupled life-years saved as compared to coverage of only the highest quintile of risk. A worst case analysis with simultaneous conservative assumptions yielded an incremental cost-effectiveness ratio of $110,000 per life-year gained. In a probabilistic sensitivity analysis, 99.74% of possible incremental cost-effectiveness ratios were <$50,000 per life-year gained. CONCLUSIONS: Heart failure disease management programs are likely cost-effective in the long-term along the whole spectrum of patient
risk. Health gains could be extended by enrolling a broader group of patients with HF in disease management.
http://www.ncbi.nlm.nih.gov/pubmed/18215605
Here is the video link
http://www.bupafoundation.co.uk/asp/awards/08_awards/health_at_work_award.asp
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