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Group Health Cooperative Shows Investing In More Primary Care Pays For Itself
An evaluation of recent innovations in delivering primary care at a Group Health Cooperative medical center shows significant success and rapid return on investment. The data led to a decision to invest in these best practices in all of Group Health"s 26 medical centers by 2010.

Study Shows Decreased Risk Of Death From Opportunistic Infections With Earlier Antiretroviral Treatment
HIV-positive people with opportunistic infections who receive earlier antiretroviral treatment lower their risk of death compared with people who delay treatment, according to a new study conducted by the Stanford University School of Medicine and published in PLoS One, the San Jose Mercury News reports. The findings could lead to changes in recommendations for antiretroviral treatment protocol, specifically for patients diagnosed with HIV at an advanced stage, the Mercury News reports. The study included 262 HIV-positive participants at 39 health care sites across the U.S., and 20 participants in South Africa. During the yearlong study, the researchers found that among the participants who were treated promptly after developing an opportunistic infection, 14% died or developed another infection. The researchers also found that 24% of participants who deferred treatment for an average of 45 days died or had a decrease in health outcomes. According to the Mercury News, the question of when to start HIV-positive people on antiretroviral treatment remains unclear because of issues such as the high cost of medicines, side effects, and drug interactions or resistance. Andrew Zolopa, head of Stanford University School of Medicine"s division of infectious diseases and lead investigator of the study, said that physicians often treat HIV-positive people for an "acute crisis, then follow up later with treatment for HIV." He continues, "But that answer is wrong. The study shows very clearly that there is no safety downside to doing this -- and the benefit is quite substantial, reducing death by 50%." "Even in San Francisco, one of the first epicenters of HIV in the United States, we still find that many people present late in the course of their illness with an opportunistic infection," Mitch Katz, director of San Francisco"s Department of Health who was not involved in the study, said. He added, "This study shows that it is lifesaving to treat those persons with antiretroviral drugs while they are still in the hospital." Katz said that the results could lead to changes in HIV/AIDS practices worldwide. The International AIDS Society, CDC and the British AIDS Society have developed guidelines recommending that early antiretroviral treatment be considered in patients with opportunistic infections, Zolopa said. In addition, NIH is considering an international study to examine earlier initiation of antiretroviral treatment involving more than 9,000 people from both developed and developing countries (Krieger, San Jose Mercury News, 5/15).
News of the day
New Survey: Health Care Leaders Say Need For Reform Is Urgent; Broadly Support Public Health Care Option, Provider Payment Reform
By a wide margin, health care leaders believe that individuals should have a choice of public and private health plans, and strongly support other central components of health reform such as innovative provider payment reform and a national insurance health exchange with strong standard-setting authority. In addition, two-thirds (68%) of opinion leaders feel it is urgent to enact comprehensive health care reform this year, according to the latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey.
Endocrinology

American Society Of Hematology Awards Grants To Encourage Novel Medical Training Programs

The American Society of Hematology (ASH) announces that Ellis J. Neufeld, MD, PhD, of Harvard Medical School, Thomas Shea, MD, of University of North Carolina at Chapel Hill, and Alvin Schmaier, MD, of Case Western Reserve University in Cleveland, will each receive ASH"s Alternative Training Pathway Grant this July. The grant is awarded to selected training program directors to encourage the development and implementation of novel hematology-related training programs in recognition of the need for more clinicians and clinical/translational researchers in hematology-related disciplines. "This program encourages creative approaches to meeting the demands of a growing number of trainees who are expressing interest in pursuing hybrid careers" said ASH President Nancy Berliner, MD, Chief of Hematology at Brigham and Women"s Hospital in Boston, and Professor of Medicine at Harvard Medical School. "We hope to expand the opportunities available to clinician-scientists interested in hematology-related careers by allowing hematology training to be enhanced and expanded by combining it with other specialties such as pathology, lab medicine, and transfusion medicine, as well as providing for combined pediatric and adult hematology training." Each recipient"s curriculum will integrate new advances and technologies into traditional hematology training programs. Specifically, Dr. Neufeld"s grant will support training for residents in both pediatric and adult hematology, Dr. Shea"s grant will support training in transitional care for adolescent and young adult survivors of childhood cancer and blood diseases, and Dr. Schmaier will receive a grant to support specialized clinical and basic research training in benign hematology. The Alternative Training Pathway Grant is awarded over a one- to two-year period and is offered to training program directors in hematology, hematology/medical oncology, and other hematology-related disciplines in the United States, Canada, and Mexico. The American Society of Hematology is the world"s largest professional society concerned with the causes and treatment of blood disorders. Its mission is to further the understanding, diagnosis, treatment, and prevention of disorders affecting blood, bone marrow, and the immunologic, hemostatic, and vascular systems, by promoting research, clinical care, education, training, and advocacy in hematology. In September, ASH launched Blood: The Vital Connection , a credible online re addressing bleeding and clotting disorders, anemia, and cancer. It provides hematologist-approved information about these common blood conditions including risk factors, preventive measures, and treatment options. American Society of Hematology

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02.05.2012


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