Ob.Gyns. Begin to E-Prescribe
About a third of ob.gyns. are actively e-prescribing in their practices, according to a new report by the Surescripts e-prescribing network. That puts ob.gyns. in the middle of the electronic pack. Cardiologists are the top e-prescribers, with 49% of using the technology regularly. Close behind are family physicians (47%), internists (45%), gastroenterologists (38%), and pediatricians (36%). About 36% of all office-based physicians were e-prescribing in 2010, and 1 in 10 prescriptions was delivered electronically, up from 1 in 18 in 2008. E-prescribing is being driven primarily by federal legislation, including health care reform, according to Surescripts. Some 326 million prescriptions were routed electronically in 2010, compared with 190 million in 2009, a 72% increase.
Episiotomies Down, C-Sections Up
The use of episiotomies fell 60% between 1997 and 2008, but cesarean sections rose 72%, according to data released by the Agency for Healthcare Research and Quality. The percentage of births by cesarean section rose from 21% in 1997 to 33% a decade later. At the same time, the rate of repeat cesareans nearly doubled, from 8% to 14%. The AHRQ report, which is based on data on inpatient hospital stays in the United States, also found that cesarean sections were more common in privately insured patients than in those without insurance. The report also noted decreases in the use of episiotomies and forceps. The use of forceps in vaginal births dropped by a third, from 14% in 1997 to 10% in 2008. About 29% of vaginal births involved episiotomies in 1997, compared with 12% in 2008, a drop of about 60% in a decade.
State Defunds Planned Parenthood
Indiana Gov. Mitch Daniels (R) has signed legislation withholding state funds from any health care entity other than hospitals or ambulatory surgery centers that provides abortions or operates with an abortion provider. The new law effectively strips state funding from Planned Parenthood clinics in Indiana. The law also bars health plans from providing coverage for abortions except in cases of rape, incest, or the risk of substantial injury to the woman. Any woman seeking an abortion would have to view fetal ultrasound imaging unless she provides a written refusal. Planned Parenthood of Indiana is challenging the law in court.
Report Finds Reform Pro-Women
The growing number of women who lack adequate health care will be aided by provisions in the Affordable Care Act, according to a report from the Commonwealth Fund. After a random national survey of 1,362 men and 1,671 women aged 19–64 years, the group calculated that 27 million women were uninsured in 2010, 42 million women had trouble paying their medical bills during the past decade, and 45 million avoided getting health care because of the cost. One of the main reasons for access problems is that women in their reproductive years face insurance premiums that are 84% higher than those for men the same age, the report asserted. However, uninsured women will gain coverage through provisions of health reform, such as increased Medicaid eligibility, subsidized private insurance in state insurance exchanges, and a ban on insurance underwriting based on health or gender, according to the report.
Headaches Take a Toll
Headaches were the main cause of 3 million emergency department visits and 81,000 hospital stays in the United States, according to an analysis of 2008 data by the Agency for Healthcare Research and Quality. Those figures represented 2.4% of ED visits and 0.2% of hospitalizations, respectively. Migraines made up one-third of the headache emergencies and two-thirds of the hospital stays for headaches. The ED visits increased during the summer months, peaked in September, and were lowest during February and December. Three-fourths of the headache sufferers were women, who also were four times as likely to have migraines as men were.
CME-Funding Dilemma Persists
Although physicians and other medical professionals say they're concerned that commercial funding of continuing medical education might bias the information provided, most are not willing to pay more to offset or eliminate such funding, a study in the Archives of Internal Medicine showed. Researchers surveyed 770 physicians, nurses, nurse practitioners, and physician assistants at CME sessions and found that the vast majority – 88% – said that commercial support of CME introduces bias. However, only 15% would eliminate commercial support from CME activities and only 42% said they were willing to pay more in an effort to cut industry financial involvement. Most CME participants also significantly underestimated the amount of commercial funding for their courses, the authors wrote, adding that “the dilemma remains of how to provide quality CME either with alternate funding or at reduced cost.”