About Covid-19
Last week, Pfizer’s CEO said the company is investigating use of a 4th dose of its Covid-19 vaccine. Below are two related international stories:
Call to offer more people fourth jab as Covid rises in England: “Scientists say that the UK government should consider extending the plan to give a fourth dose of COVID vaccines to older people because of evidence of waning immunity, The Guardian reported.
Figures show that one in 25 people, or 3.8% of England's population, was infected on March 5, and research by the React-1 study indicated that cases are rising in those aged 55 and over.”
France to launch fourth COVID shot for over-80s, PM says: “French Prime Minister Jean Castex said the country will start offering a fourth COVID-19 vaccine to people over 80 years old who had their previous booster dose more than three months ago, as reported in National Post.”
About health insurance
Small Practice Participation and Performance in Medicare Accountable Care Organizations: “We conducted a modified difference-in-differences analysis that allowed us to compare large vs small practices before and after the Medicare Shared Savings Program (MSSP) ACO started, between 2010 and 2016. Our sample included Medicare fee-for-service beneficiaries with 12 months of Medicare Part A and Part B (unless death) who were attributed to small (≤ 15 providers) and large (> 15 providers) practices participating in ACOs and non-ACOs. The outcome was patient annual spending based on CMS’ total per capita costs.
Results: Patients attributed to small practices in ACOs had annual Medicare spending decreases of $269 (95% CI, $213-$325; P < .001) more than patients attributed to large practices in ACOs. Small ACO practices reduced spending more than large practices by $165 for physician services (95% CI, $140-$190; P < .001), $113 for hospital/acute care (95% CI, $65-162; P < .001), and $52 for other services (95% CI, $27-$77; P < .001). Small practices in ACOs spent $253 more on average at baseline than small practices in non-ACOs. ACOs with a higher proportion of small practices were more likely to receive shared savings payments.
Conclusions: Small practices in ACOs controlled costs more so than large practices. Small practice participation may generate higher savings for ACOs.”
About pharma
Ohio Doctor Sentenced for Overprescribing Painkillers, Fraud: “A doctor in Ohio who denied doing any harm to his patients after being convicted of overprescribing painkillers has been sentenced to five years in prison.
A federal judge on Thursday also ordered Dr. William Bauer of Port Clinton to pay $460,000 in restitution.
Bauer, 85, was convicted last summer on charges of distributing controlled substances at his office in Bellevue and healthcare fraud.
Federal prosecutors said he prescribed dangerous drug combinations and high doses of addictive narcotics that weren’t medically necessary.”
About the public’s health
Trends in Diet Quality Among Older US Adults From 2001 to 2018: “In this cross-sectional study of 10 837 adults aged 65 years or older in the National Health and Nutrition Examination Survey, the mean primary American Heart Association score had a significant 8% decrease. The proportion of older US adults with poor diet quality significantly increased from 51% to 61%, and the proportion with intermediate diet quality significantly decreased from 49% to 39%; the proportion of older US adults with ideal diet quality remained consistently low.”
Inverse Association Between Variety of Proteins With Appropriate Quantity From Different Food Sources and New-Onset Hypertension: “The variety score of protein sources was defined as the number of protein sources consumed at the appropriate level, accounting for types and quantity of proteins. New-onset hypertension was defined as systolic blood pressure ≥140 mm Hg and diastolic blood pressure ≥90 mm Hg, or physician-diagnosed hypertension or receiving antihypertensive treatment, during the follow-up. During a median follow-up of 6.1 years, there were U-shaped associations of percentages energy from total, unprocessed or processed red meat-derived, whole grain-derived, and poultry-derived proteins with new-onset hypertension; an reverse J-shaped association of fish-derived protein with new-onset hypertension; L-shaped associations of eggs-derived and legumes-derived proteins with new-onset hypertension; and an reverse L-shaped association of refined grain-derived protein with new-onset hypertension (all P values for nonlinearity <0.001). That is, for each protein, there is a window of consumption (appropriate level) where the risk of hypertension is lower. Moreover, a significantly lower risk of new-onset hypertension was found in those with higher variety score of protein sources (per score increment, hazard ratio, 0.74 [95% CI, 0.72–0.76]). In summary, there was an inverse association between the variety of proteins with appropriate quantity from different food sources and new-onset hypertension.”
In this Chinese study, data was gathered from subject’s recall. Nevertheless, the findings are intriguing.
Millions suffering in deadly pollution ‘sacrifice zones’, warns UN expert: “In a report … presented to the UN human rights council on Thursday, Boyd says pollution contributed to twice as many premature deaths as Covid-19 in the first 18 months of the coronavirus pandemic.
Giving the death toll from pollution in that period is a staggering 9 million, the report adds: ‘One in six deaths in the world involves diseases caused by pollution, three times more than deaths from Aids, malaria and tuberculosis combined and 15 times more than from all wars, murders and other forms of violence.’”
About quality and safety
ECRI: Top 10 Patient Safety Concerns 2022:
1. Staffing shortages
2. COVID-19 effects on healthcare workers’ mental health 3. Bias and racism in addressing patient safety
4. Vaccine coverage gaps and errors
5. Cognitive biases and diagnostic error
6. Nonventilator healthcare-associated pneumonia
7. Human factors in operationalizing telehealth
8. International supply chain disruptions
9. Products subject to emergency use authorization
10. Telemetry monitoring