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Yolo County, Calif., Approves Proposal To Cut Funding For Health Care Services To Undocumented Immigrants
Yolo County, Calif., Board of Supervisors on Tuesday approved a proposal to cut county funding for health care services for undocumented immigrants in an effort to save the county more than $1 million, the Sacramento Bee reports (Sangree, Sacramento Bee, 5/20).California counties have been taking such action amid the economic recession to reduce their budgets. In February, Sacramento County voted to prohibit undocumented immigrants from receiving care at county clinics to save an estimated $2.4 million. Contra Costa County last month cut services for undocumented adults, seeking to save an estimated $6 million. Yolo County is facing a $24 million budget deficit for fiscal year 2009-2010 (Kaiser Health Disparities Report, 5/7).Robin Affrime -- head of CommuniCare Health Centers, which provide treatment to low-income residents of Woodland, Davis and West Sacramento -- said the county spending cuts would shift costs to health care providers. Supervisor Jim Provenza said undocumented immigrants would delay care at clinics and eventually seek treatment in hospital emergency departments (Sacramento Bee, 5/20).
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Physicians Wait For Health IT Guidelines, Officials Want 'Every Doctor's Office' Online
Physicians are still waiting for clear cut rules for how they must use health information technology in order to be eligible for economic stimulus-funded incentives, American Medical News, a publication of the American Medical Association, reports. The publication notes that (the $2 billion) "incentive money will directly address the use of EMRs, not the purchase of the systems." The sole, ambiguous requirement - that doctors must make "meaningful use" of the technology - will be defined by year"s end. But, industry consultants say doctors can and should get a head start on the governments expectation that they"ll be able to adopt the technology by 2011. Practices can expect requirements to include e-prescribing, certification through a government-approved certifying body, quality reporting, and the ability of one system to exchange information with others (Dolan, 6/15).
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Better Hearing With Bone Conducted Sound
New technology to hear vibrations through the skull bone has been developed at Chalmers University of Technology. Besides investigating the function of a new implantable bone conduction hearing aid, Sabine Reinfeldt has studied the sensitivity for bone conducted sound and also examined the possibilities for a two-way communication system that is utilizing bone conduction in noisy environments.
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Comparison Is Key To Lower Costs, Better Outcomes From Medications

Patients can expect significant savings and better outcomes from their prescription medications when health care professionals use comparative effectiveness research, according to researchers at the University of Illinois at Chicago. The American Recovery and Reinvestment Act signed by President Obama includes more than $1 billion over the next two years for comparative effectiveness research, a practice that evaluates different options for treating a medical condition among a certain group of patients. "Despite having the highest per capita health care expenditures in the world, the United States does not always perform well on measures of health compared with other countries," said Glen Schumock, associate professor and director of the UIC Center for Pharmacoeconomic Research. "With prescription drugs accounting for more than 10 percent -- $227.5 billion -- of the total amount Americans spent on health care in 2007, we need to know more about how drugs compare to one another in terms of effectiveness, safety, and value for money." The analysis is published in the online version of American Journal of Health-Systems Pharmacy and is co-authored by A. Simon Pickard, UIC associate professor of pharmacy practice. Comparative effectiveness is a relatively new concept, and it contains two important components, Schumock said. It provides information to help clinicians choose among alternative treatments, and it examines outcomes in actual practice. Randomized control trials have long been the most widely accepted method to study the efficacy of innovative medical care interventions, and they are required by the U.S. Food and Drug Administration to market a new drug, Schumock said. However, such trials have drawbacks. A traditional randomized control trial does not show how the drug works, Schumock said, "and it usually compares a new drug with a placebo or an inferior treatment option rather than the drug or drugs that might be legitimate therapeutic alternatives." The patient populations are also narrowly selected, and are usually healthier than the patients who will eventually use the drug, he said. Comparative effectiveness studies matches up comparable medications based on current choices available to health care professionals. The patients are those who actually use the drug once it is marketed. The outcomes, Schumock said, are more relevant to decisionmaking at the clinical or policy level. Comparative effectiveness research may reduce spending on pharmaceuticals and lower overall health care costs, said Pickard. According to the Congressional Budget Office, direct spending by the federal government -- mostly for Medicare and Medicaid -- would be reduced by $100 million from 2008-2012 and $1.3 billion from 2008-2017. Those figures could be much higher, as they were developed before the recent large investment in comparative effectiveness research, Pickard said. "With the shared goal of improving decisionmaking at every level of the health care system, pharmacy and other professions can use comparative effectiveness research as an opportunity to be more efficient and more accountable," Pickard said. University of Illinois at Chicago


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