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Boston Globe Examines Hospital's Attempt To Reduce Emergency Department Visits, Hospital Stays Among Elderly
Efforts by Massachusetts General Hospital to reduce health spending could be indicative of the difficulty the health industry faces in trying to reduce spending growth, the Boston Globe reports. Industry groups last week pledged to seek a 1.5% overall reduction in health care spending over the next 10 years.Massachusetts General"s program, which began in 2006, aims to reduce hospitalizations among the elderly by 15% to 20%, as well as to improve the quality of care the elderly receive. A study looking at 35 efforts to improve elderly care found that only six, including Massachusetts General"s program, saved money or covered their costs, the Globe reports. Massachusetts General"s program relies on nurses in primary care practices to be in regular contact with patients and provide assistance with nonmedical services. The program also uses electronic health records to coordinate care. The hospital spent $8 million to $9 million over the first three years of the program to provide enhanced services to patients. Hospital readmissions fell by 19%, admissions decreased by 17% and ED visits dropped by 15% between 2007 and 2008, according to preliminary research. The program saved enough by reducing hospital admissions and emergency department visits to cover its costs and also to generate savings of $7 million to $10 million. The overall cost for the program was about 5% less than for a group of other patients treated in a more traditional way.According to Harvard University health care economist David Cutler, improving care and reducing costs among the elderly is a necessary component of health reform. He said, "If we can"t do this, it doesn"t bode well for health reform." Eric Weil, a primary care physician and medical director of the program at Massachusetts General, said, "Medicare is looking for any and every way to save money," adding, "This is a population of patients who are sick and will get sicker over time. Any opportunity to demonstrate savings in this group of patients is good, and 5% is very good" (Kowalczyk, Boston Globe, 5/17).

Fertility Donor Debate, UK
Dr Gedis Grudzinskas the UK-based fertility expert issued the following statement in response to the statement by the Human Fertilisation and Embryology Authority:
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Advanced Melanoma: Vaccine Shows Therapeutic Promise
A vaccine for one of the most lethal cancers, advanced melanoma, has shown improved response rates and progression-free survival for patients when combined with the immunotherapy drug, Interleukin-2, according to researchers from The University of Texas M. D. Anderson Cancer Center.
Cardiovascular

For Struggling Single Moms, 3-Generation Households Are Better Than 2

Living in a three-generation household can significantly enhance the economic well-being of children, according to a new study from researchers at the University of Southern California and the University of Massachusetts, Boston. Their findings, to appear in the November 2009 Journal of Family Issues and now available online, indicate children living in single-mother families that also include a grandparent are substantially less likely to be living below or near the poverty line compared to children living in mother-only homes. "The implications of this research are particularly salient as we are facing an unprecedented economic crisis in the United States " said Lindsey A. Baker of the USC Davis School of Gerontology, co-author of the study. "Multigenerational co-residence will likely be a strategy used by many to deal with financial hardship caused by the loss of a job, house or retirement savings. In the United States, more than six million children under the age of 18 live with at least one grandparent. Of these children, 2.5 million are part of a single-mother family that includes the child"s mother as well as one or more grandparents. Using data from the Survey of Income and Program Participation from 2001, the researchers found that the presence of just one grandparent makes the odds of living below the poverty line 80% lower than for children living without a grandparent, and children living with two grandparents are at an even greater advantage. In the United States, the average income of a family with two grandparents is more than double the income of a single-mother household with no grandparents ($63,635 compared to $27, 619), the researchers found. In addition, the study also reveals that the largest single of income in single-mother, three-generation homes is the contributions of grandparents, including cash transfers and Social Security income, Baker said. "The pooling of res has long been identified as a benefit of household extension," said lead author Jan E. Mutchler of the University of Massachusetts, Boston. "The easing of financial difficulties has been highlighted as an important goal motivating the formation of multigenerational households. Grandparents are often the first families members called upon when families are troubled or in need." The research was made possible by grant #R03 HD043333 from the National Institute of Child Heath and Human Development and training grant # T32-AG00037 from the National Institute on Aging. Suzanne Wu University of Southern California


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