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Sleep Laboratory Finds Insomnia With Short Sleep Duration Is A Risk Factor For Diabetes
Individuals with insomnia and objective short sleep duration are at increased risk for developing diabetes, according to a research abstract presented at SLEEP 2009, the 23rd Annual Meeting of the Associated Professional Sleep Societies.
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European Travellers Continue To Put Their Health At Risk
European travellers are still putting their health at risk says the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), with one third experiencing travel-related illness when visiting abroad. On a typical two-week trip, travellers lose an average of three days due to illness - almost 20 percent of them remain ill after their return home, and another 10 percent need medical care.
News of the day
House Democrats Unveil Health Care Reform Proposal
House Democratic leaders on Tuesday unveiled a health care reform bill that aims to extend coverage to 37 million U.S. residents over 10 years, the Washington Post reports. According to Democratic aides, the bill would ensure that 97% of U.S. residents are insured by 2015 (Montgomery/Connolly, Washington Post, 7/15). The bill would require employers and individuals to get health insurance coverage or pay into a fund (AP/Google.com, 7/14). To help people obtain insurance, the bill would increase Medicaid eligibility and provide tax credits to those with incomes up to 400% of the federal poverty level, or about $43,000 for an individual (Washington Post, 7/15). The bill would establish a government-run public plan option designed to compete with private insurers (Frank, Reuters, 7/14). The bill also includes several provisions designed to slow the growth of Medicare (Pear/Herszenhorn, New York Times, 7/15).The bill does not include total cost figures, and it is unclear whether last-minute changes by its sponsors would satisfy moderate and conservative Democrats who last week refused to support the legislation, according to the AP/Google.com (AP/Google.com, 7/14). The Congressional Budget Office estimated yesterday that the bill would cost $1 trillion over 10 years, though more information is needed before final cost estimates are released. A new surtax on higher-income residents is projected to cover more than half of the bill"s cost over 10 years, with smaller amounts of funding from changes to the corporate tax code, according to the Post (Washington Post, 7/15).
Cardiovascular

Study: Bariatric Surgery Patients Have 67 Percent Lower Chance Of Complications At Top-Performing Hospitals

The HealthGrades Fourth Annual Bariatric Surgery Trends in American Hospitals Study released today identifies 88 hospitals as "best" performers (five-star rated), with mortality rates, complication rates and patient lengths of stay that are dramatically lower than poorly rated hospitals. In the study, HealthGrades, the nation"s leading independent healthcare ratings organization, evaluated the quality of bariatric surgery in hospitals across 19 states that provide all-payer information. The recipient list and full study results can be found at http://www.healthgrades.com. As other studies have found, high bariatric surgery volumes correlated with better inhospital outcomes. In this study, higher-volume programs, those with greater than 375 cases over three years, have a 32 percent lower risk of patient complications than lower volume programs, those with less than 75 cases over three years. California was, on average, the most expensive state for bariatric surgery, with an average charge per procedure of $52,224, the study found. Maryland was the least expensive with an average charge per procedure of $14,577. Bariatric surgery is a general term describing several types of weight loss procedures. The HealthGrades study analyzed the outcomes of the most common including gastric bypass procedures, less invasive laparoscopic procedures including gastric banding, malabsorbtive procedures and combined malabsorbtive/restrictive procedures. Due to the growing number of obese Americans and the explosion of bariatric surgery programs in the U.S., patients have many choices when it comes to selecting a program. This study has found a wide variation in the quality and outcomes of these programs. Because bariatric surgery is an elective procedure, patients have the time to thoroughly investigate their surgeon and hospital before making a decision on where to have surgery performed. "Due to the wide gap in quality we see among bariatric surgery programs, we encourage patients to carefully evaluate the volume and inhospital outcomes of the bariatric program they are considering," said Rick May, MD, a senior physician consultant with HealthGrades and a co-author of the study. "Hospitals designated as five-star for bariatric surgery have best practices that drive their exceptional outcomes." Other findings identified in the study include: - Bariatric surgery patients treated at top-rated hospitals have, on average a 67 percent lower chance of experiencing serious complications compared to patients who receive treatment at poorly rated hospitals. - Patients having surgery at five-star hospitals spent, on average, more than half a day less in the hospital (2.15 days) compared to patients having surgery in one-star hospitals (2.72 days). - Of the 19 states studies, over 61% of all procedures were performed in five states: New York, Texas, Pennsylvania, California and Florida. - Patients in Vermont, on average, spent the most time in the hospital (3.26 days), while patients in Nevada, on average, spent the least amount of time in the hospital (1.56 days). - The number of inpatient procedures during the study years 2005 through 2007 showed no significant increase, but an increasing percentage of surgeries are being performed outpatient. - More Center of Excellence bariatric surgery programs earned a five-star rating (29.5%) than non-COE programs (12.3%). - Laparospcopic bariatric surgery procedures account for 79% of all procedures, up from 54% in last year"s study. - Patients had a three times lower inhospital death rate associated with a bariatric surgery if they had it performed at a five-star hospital versus a one-star hospital. Methodology For this study, HealthGrades analyzed 153,355 bariatric procedures performed in the years 2005, 2006 and 2007. The states included in the study are: Arizona, California, Florida, Iowa, Maine, Maryland, Massachusetts, Nevada, New Jersey, New York, Oregon, Pennsylvania, Rhode Island, Texas, Utah, Vermont, Virginia, Washington, and Wisconsin. To make accurate and valid comparisons of clinical outcomes at different hospitals with different patient characteristics, HealthGrades risk adjusted the data using multivariate logistic regression to account for age, gender and underlying medical conditions that could increase the patient"s risk of mortality or complication. The full study and individual hospital ratings for bariatric surgery and other procedures can be found at http://www.healthgrades.com. Individuals contemplating bariatric surgery will find both quality and cost information at http://www.healthgrades.com. In addition to the free hospital-quality ratings, Web site visitors can also research surgeons who perform bariatric surgery as well as medical-cost reports that detail all of the costs, including out-of-pocket expenses, for the procedure. HealthGrades


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