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Quality Measures Improve Outcomes More Than Hospital Volume Alone
A new study by researchers at the University of California, San Francisco and Baystate Medical Center at Tufts University in Massachusetts concludes that patients facing coronary artery bypass surgery should, as a first priority, select a medical facility that has the highest adherence to quality standards.
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Tiller Murder Increases Tension Over 'Common Ground' Approach To Abortion-Rights Debate
The recent murder of Kansas abortion provider George Tiller has increased tensions between groups on both sides of the abortion debate at a time when the White House is advocating a move toward "common ground" on the issue, the Los Angeles Times reports. Tiller, one of the few doctors who performed abortions later in pregnancy, was shot to death in his church on Sunday. According to the Times, some advocates feel that the murder will further complicate the Obama administration"s efforts to find areas for agreement in the abortion-rights debate. Abortion-rights advocate Cristina Page -- an author and blogger who attended initial White House meetings on forming effective reproductive health policies -- called Tiller"s death a "massive setback" to the idea of finding common ground with abortion-rights opponents. She added that it is "sort of like having a family member murdered and then being asked to make nice with the assassin"s family. It"s unnatural." However, some antiabortion-rights groups say that President Obama"s policy moves, such as his proposal to rescind the Bush administration"s provider "conscience" rule, have undercut his calls for compromise. Marjorie Dannenfelser, president of the Susan B. Anthony List, said, "It is very hard to find common ground when none of your policies overlap with the people you are trying to find common ground with."The Obama administration in the coming months plans to continue meetings with advocates on both sides of the abortion debate as it drafts policy proposals aimed at preventing unintended pregnancies and reducing the need for abortion, the Times reports. According to the Times, one area of debate that arose after the first meeting was the White House"s distinction between reducing the need for abortion versus some antiabortion-rights advocates" focus on reducing the number of abortions. After the meeting, Wendy Wright, president of the antiabortion-group Concerned Women for America, blogged that she disagreed with abortion-rights advocates" objections to the phrase "reducing abortions." Page said that Wright seemed to aim to start a fight over words to impede discussion. "We"ve gotten dragged very quickly, by [Wright], back to the same debate that we"ve all suffered through for 36 years," Page said. Nancy Northup, president of the Center for Reproductive Rights, said that the "issue should be reducing the number of unintended pregnancies." Melody Barnes, head of Obama"s Domestic Policy Council, said in an interview in May that the White House"s "goal is to reduce the need for abortions.÷ ... If people have better access to contraception, that"s a way of addressing the issue at its root, rather than do a tally of abortions" (Wallsten/Abcarian, Los Angeles Times, 6/3).
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Can A Society With Smokers Be Profitable?
The latest rise in the indirect taxation on tobacco and alcohol took place in June. The most popular brand of cigarettes went up in price from 3.10 euros to 3.30 euros per packet. Are these taxes a form of dissuasion or a way of compensating the rest of society for the harm generated by those who smoke? A study by the Polytechnic University of Cartagena has looked into the most significant questions concerning the tobacco economy.
Public Health

Filling The Gap Between The ER And The Family Doctor: Urgent Care Centers

Urgent care centers (UCCs) are providing an alternative to emergency room treatment. A study published in the open access journal BMC Health Services Research has shown that UCCs tend to be open well outside of office hours and offer a wider range of services than primary care offices. Robin Weinick, from the RAND Corporation, worked with Steffanie Bristol and Catherine DesRoches from Massachusetts General Hospital and Harvard Medical School to investigate the organization and function of UCCs. Weinick said, "This is the first piece of research that"s taken a nationally representative sample to look at urgent care centers. Given their extended hours, availability of unscheduled appointments, and the range of services they provide, urgent care centers are uniquely positioned within the health care system to address the overflow of acute care patients from primary care as well as low- to mid-acuity emergency department patients". The researchers found that the centers employ significant numbers of family physicians, and are slightly larger on average than office-based practices nationally. They have hours of operation expanded significantly beyond typical office hours, while also providing services such as fracture care, suturing lacerations and x-rays, which are more commonly associated with the emergency department. The study was funded by the Urgent Care Association of America. Weinick said, "A significant shortage of primary care physicians is predicted over the next two decades, and more than one quarter of family physicians are not currently accepting new Medicare fee-for-service patients. At the same time, despite having fewer emergency departments nationally, demand for their services continues to grow. Given this combination, demand for urgent care center services may increase as well". Urgent care centers in the U.S.: Findings from a national survey Robin M. Weinick, Steffanie J. Bristol and Catherine M. DesRoches BMC Health Services Research (in press) http://www.biomedcentral.com/bmchealthservres/ Graeme Baldwin BioMed Central


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