Leading consumer advocacy groups have joined with the Surgical Care Improvement Project (SCIP) to improve patient safety during surgery and increase communication between patients and their caregivers.
Of the 40 million inpatient and outpatient surgeries patients undergo each year, tens of thousands end up with associated postoperative complications. SCIP is working to prevent complications in four areas that comprise 40 percent of the most common complications after major inpatient surgery: infection, blood clots, and adverse cardiac and respiratory events.
SCIP is one of the first national quality improvement initiatives to unite hospital, physician and nursing organizations; the federal government; the organization that accredits hospitals; private sector experts; and now consumer advocacy groups in far-reaching surgical quality improvement. The goal is to use evidence-based measures to reduce preventable surgical complications nationwide by 25 percent by 2010.
The consumer groups - AARP and the National Partnership for Women and Families - collaborated with SCIP to develop a patient tip sheet that provides consumers with important information on ways to avoid surgical complications.
The tip sheet was introduced at a Washington, D.C., event today that featured Mike Leavitt, Secretary of the U.S. Department of Health and Human Services; Ilene Corina, co-founder of PULSE, a grassroots patient safety advocacy organization; and other SCIP members.
"Consumers and patients need information that will help them become active partners in their care," said John Rother, AARP's Group Executive for Policy and Strategy. "SCIP supports improvement not only for hospitals and doctors, but for patients as well by giving them practical and actionable guidance that will contribute to the likelihood of better surgical outcomes."
"Our goal is to spread this evidence-based knowledge to the public as well as health care providers, so that every surgical patient receives the appropriate care every time. In doing this, we will save many thousands of lives," said Debra Ness, President, National Partnership for Women & Families.
"SCIP is a national quality initiative that aligns with one of the five key strategies of the CMS Quality Roadmap: CMS must work collaboratively with other health care partners in improving health care quality," said Barry Straube, M.D., Chief Medical Officer and Director of the Office of Clinical Standards and Quality at HHS' Centers for Medicare & Medicaid Services. "SCIP will allow consumers to be better informed and enable health providers to make the necessary systematic improvements that CMS and its partners feel will improve patient outcomes, while reducing avoidable complications and costs."
The tip sheet, "Steps to Safer Surgery," provides specific questions patients can ask their physicians and nurses before surgery to ensure they are receiving care that will reduce their risk of having complications. The tip sheet and additional information about SCIP can be found at ofmq/qiosc_scip.html.
About SCIP
The Agency for Healthcare Research and Quality, American College of Surgeons, American Hospital Association, American Society of Anesthesiologists, Association of periOperative Registered Nurses, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services, Institute for Healthcare Improvement, Joint Commission on Accreditation of Healthcare Organizations and Veterans Health Administration all work on the SCIP project.
For more information about SCIP, please visit medqic/scip.
суббота, 14 мая 2011 г.
Free Personal Care For Older People In Their Own Home, UK
Alzheimer's Society has today welcomed the recognition of people with dementia in the Queen's speech and called for dementia to be a priority for all political parties.
Responding to proposals to give people with the highest needs free personal care, Alzheimer's Society called for more detail and warned that both money and improved quality of home care was needed to make proposals a success.
'Free personal care at home for those with the highest needs is a welcome development but the challenge to implement this proposal will not be easy. Money is needed to make sure people with dementia aren't being pushed into full time care earlier than needed. Quality also needs to be driven up for people to see real benefit.
'Today's measures will not fix the crumbling system of funding for social care. Problems still loom as the number of people with dementia will double in the next generation and costs triple. We need a robust funding system that provides good care at a fair price for people at every stage of their condition. Dementia is the biggest health and social care challenge of our generation. It must be made a political priority for every party.'
Neil Hunt
Chief Executive
Source
Alzheimer's Society
Responding to proposals to give people with the highest needs free personal care, Alzheimer's Society called for more detail and warned that both money and improved quality of home care was needed to make proposals a success.
'Free personal care at home for those with the highest needs is a welcome development but the challenge to implement this proposal will not be easy. Money is needed to make sure people with dementia aren't being pushed into full time care earlier than needed. Quality also needs to be driven up for people to see real benefit.
'Today's measures will not fix the crumbling system of funding for social care. Problems still loom as the number of people with dementia will double in the next generation and costs triple. We need a robust funding system that provides good care at a fair price for people at every stage of their condition. Dementia is the biggest health and social care challenge of our generation. It must be made a political priority for every party.'
Neil Hunt
Chief Executive
Source
Alzheimer's Society
Canadians Send Clear Signal That Family Caregivers Need More Help
A large majority of Canadians - 88 per cent - say that providing care or assistance for a family member would have a negative impact on their financial situation, according to a poll released today by the Canadian Cancer Society. And of those 88 per cent, 57 per cent say it would have a major negative impact.
Poll results also show that:
- women would likely be the primary family caregiver, with 70 per cent saying they would take on this role (compared to 58 per cent of men). Yet women are the least likely (37 per cent) to be able to take unpaid time off work to provide support to a family member (compared to 59 per cent of men).
- 84 per cent of Canadians say increased financial support for family caregivers should be a priority healthcare issue in the next federal election.
"Many caregivers suffer financial difficulties as they deplete personal savings and take unpaid time off from work to care for a family member," says Dan Demers, Director, Public Issues, Canadian Cancer Society. "Canadians are greatly concerned about this issue and are looking to our federal political parties for solutions."
This is an issue that demands action now as Canada's population is aging and increasingly Canadians will be caring for loved ones who have cancer and other serious illnesses.
Federal budget
"Currently some government support exists for family caregivers, but it's simply not adequate," says Demers. "We urge the government to pay attention to the clear messages being sent by Canadians and to include more financial support for family caregivers in the upcoming federal budget."
Federal election
As political parties prepare for the next federal election, the Society will be reminding them that caregiving is an important family issue and financial support for caregivers should be included in their election platforms.
"This would show Canadians - especially women who are affected most by this issue - that politicians are listening to their concerns," says Demers. "Canadians should consider voting for the party that commits to providing more support for family caregivers. An effective and compassionate society helps families who are caring for sick loved ones."
The Society has been advocating for better financial support for family caregivers through improvements to the Compassionate Care Benefit, which is administered by the federal employment insurance program. These improvements include:
- Timeframe for financial benefits: Increase the benefit period from the current six weeks to 26 weeks, accessible during a 52-week period.
- More flexibility: allow people to claim benefits for partial weeks taken over a longer period, rather than blocks of weeks at a time.
- Revise eligibility criteria: change the terminology for people eligible for benefits from "significant risk of death" to "significant need of caregiving due to a life threatening illness."
- Amend the Canada Labour Code to protect the jobs of caregivers.
The Society also believes that a non-taxable, monthly Family Caregiver tax benefit should be established to help family caregivers with costs;
Snapshot of Canadian family caregiver
The following information comes from reports about caregivers and Statistics Canada.
- In 2009, the economic contribution of family caregivers in Canada was estimated to be between $25-26 billion.
- 41 per cent of family caregivers used their personal savings to survive.
- Between 2002 and 2007 the number of family caregivers in Canada, aged 45 years and older, increased by 30 per cent (over 670,000 people). In 2007, the number of family caregivers, aged 45 years and older, was 2.7 million.
- 65 per cent of households with a caregiver report a combined income of less than $45,000 and 23 per cent reported less then $20,000.
About the poll
From January 21 to January 24, 2011, Pollara conducted an online survey on behalf of the Canadian Cancer Society among a randomly-selected, representative sample of 2,231 Canadians, aged 18 and over. As a guideline, the margin of sampling error typically associated with a sample of this size would be +/- 2.1%, 19 times out of 20. The results of the survey have been statistically weighted according to Statistics Canada's most recent Census data for age, gender, and region to ensure that the sample is representative of the entire adult population of Canada.
Poll results also show that:
- women would likely be the primary family caregiver, with 70 per cent saying they would take on this role (compared to 58 per cent of men). Yet women are the least likely (37 per cent) to be able to take unpaid time off work to provide support to a family member (compared to 59 per cent of men).
- 84 per cent of Canadians say increased financial support for family caregivers should be a priority healthcare issue in the next federal election.
"Many caregivers suffer financial difficulties as they deplete personal savings and take unpaid time off from work to care for a family member," says Dan Demers, Director, Public Issues, Canadian Cancer Society. "Canadians are greatly concerned about this issue and are looking to our federal political parties for solutions."
This is an issue that demands action now as Canada's population is aging and increasingly Canadians will be caring for loved ones who have cancer and other serious illnesses.
Federal budget
"Currently some government support exists for family caregivers, but it's simply not adequate," says Demers. "We urge the government to pay attention to the clear messages being sent by Canadians and to include more financial support for family caregivers in the upcoming federal budget."
Federal election
As political parties prepare for the next federal election, the Society will be reminding them that caregiving is an important family issue and financial support for caregivers should be included in their election platforms.
"This would show Canadians - especially women who are affected most by this issue - that politicians are listening to their concerns," says Demers. "Canadians should consider voting for the party that commits to providing more support for family caregivers. An effective and compassionate society helps families who are caring for sick loved ones."
The Society has been advocating for better financial support for family caregivers through improvements to the Compassionate Care Benefit, which is administered by the federal employment insurance program. These improvements include:
- Timeframe for financial benefits: Increase the benefit period from the current six weeks to 26 weeks, accessible during a 52-week period.
- More flexibility: allow people to claim benefits for partial weeks taken over a longer period, rather than blocks of weeks at a time.
- Revise eligibility criteria: change the terminology for people eligible for benefits from "significant risk of death" to "significant need of caregiving due to a life threatening illness."
- Amend the Canada Labour Code to protect the jobs of caregivers.
The Society also believes that a non-taxable, monthly Family Caregiver tax benefit should be established to help family caregivers with costs;
Snapshot of Canadian family caregiver
The following information comes from reports about caregivers and Statistics Canada.
- In 2009, the economic contribution of family caregivers in Canada was estimated to be between $25-26 billion.
- 41 per cent of family caregivers used their personal savings to survive.
- Between 2002 and 2007 the number of family caregivers in Canada, aged 45 years and older, increased by 30 per cent (over 670,000 people). In 2007, the number of family caregivers, aged 45 years and older, was 2.7 million.
- 65 per cent of households with a caregiver report a combined income of less than $45,000 and 23 per cent reported less then $20,000.
About the poll
From January 21 to January 24, 2011, Pollara conducted an online survey on behalf of the Canadian Cancer Society among a randomly-selected, representative sample of 2,231 Canadians, aged 18 and over. As a guideline, the margin of sampling error typically associated with a sample of this size would be +/- 2.1%, 19 times out of 20. The results of the survey have been statistically weighted according to Statistics Canada's most recent Census data for age, gender, and region to ensure that the sample is representative of the entire adult population of Canada.
Associated Press Examines Drug Disposal Practices Of Hospitals, Long-Term Care Facilities
Hospitals, hospices and nursing homes dump at least 250 million pounds of unused medications and contaminated packaging into the U.S. drinking water supply each year, according to an ongoing Associated Press investigation, the AP/San Francisco Chronicle reports. The Associated Press based the estimate on a small sample, as few of the 5,700 hospitals and 45,000 long-term care facilities maintain records on the amount of unused medications of which they dispose.
According to the AP/Chronicle, the medications "are expired, spoiled, over-prescribed or unneeded." And others "are simply unused because patients refuse to take them, can't tolerate them or die with nearly full 90-day supplies of multiple prescriptions on their nightstands." The "enormous amount of pharmaceuticals being flushed by the health services industry is aggravating an emerging problem," the AP/Chronicle reports. The Environmental Protection Agency has begun to consider a national standard for the amount of unused medications of which health care facilities can dispose in drinking water, but the agency likely would not finalize such a standard before 2009, according to EPA official Ben Grumbles(Donn et. al, AP/San Francisco Chronicle, 9/21).
According to the AP/Chronicle, the medications "are expired, spoiled, over-prescribed or unneeded." And others "are simply unused because patients refuse to take them, can't tolerate them or die with nearly full 90-day supplies of multiple prescriptions on their nightstands." The "enormous amount of pharmaceuticals being flushed by the health services industry is aggravating an emerging problem," the AP/Chronicle reports. The Environmental Protection Agency has begun to consider a national standard for the amount of unused medications of which health care facilities can dispose in drinking water, but the agency likely would not finalize such a standard before 2009, according to EPA official Ben Grumbles(Donn et. al, AP/San Francisco Chronicle, 9/21).
Controlled Substances
Narcotics and other controlled substances are the forms of medications most likely to contaminate the drinking water supply, the AP/Chronicle reports. According to the AP/Chronicle, hospital environmental administrators maintain that federal regulations on narcotics, stimulants, depressants and steroids "make these drugs nearly impossible to handle safely as waste." Drug Enforcement Administration spokesperson Rogene Waite said, "DEA is currently developing regulations to allow for the safe and effective destruction of controlled substances" (Donn, AP/San Francisco Chronicle, 9/21).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Half-Million Dollar Surety Bond Requirement Would Put Many Small Durable Medical Equipment Providers Out Of Business
A Senate bill introduced last week would impose a $500,000 surety bond requirement on providers of durable medical equipment (DME) under Medicare and would put thousands of small homecare companies out of business, says the American Association for Homecare.
A law passed in 1997 requires a $50,000 surety bond for DME providers as a deterrent to fraud and abuse. However, the federal government has never actually implemented the surety bond requirement for the DME sector. The Centers for Medicare and Medicaid Services has proposed that the amount increase to $65,000.
The bill introduced last week, S. 2603, called the "Medicare Fraud Prevention Act of 2008," would increase the $50,000 surety bond requirement by a factor of ten. The bill would also increase civil and criminal fines for Medicare fraud and abuse. The bill is sponsored by Senators Mel Martinez (R-Fla.), John Cornyn (R-Texas), Norm Coleman (R-Minn.), Lamar Alexander (R-Tenn.), David Vitter (R-La.) and Jim DeMint (R-S.C.).
"The impact of a half-million dollar surety bond requirement would be devastating on law-abiding small providers," said Tyler J. Wilson, president of the American Association for Homecare. "This provision would put a lot of home medical equipment providers out of business without fixing the fraud and abuse problem. No one is more concerned about getting criminals out of Medicare than the homecare sector, but this is clearly a case of throwing the baby out with the bathwater. Why would the government increase the surety bond by 1000 percent before it has even implemented the original amount?"
Insurance experts say a $500,000 surety bond would require that DME providers put up collateral to back the half-million-dollar bond, on top of the $10,000 to $20,000 cost of the bond.
"The American Association for Homecare welcomes and supports efforts to eliminate Medicare fraud. The Association continues to work with federal agencies and Congress to prevent fraudulent activity in the DME sector. However, it is essential for the public and Congress to understand that the Medicare program has failed to effectively exercise its already ample authority to combat fraud and abuse," Wilson stated. "And while increased civil and criminal penalties may help thwart fraud and abuse in Medicare, we suspect that most of the people who willingly engage in such activity will not be deterred by higher penalties."
Since the early 1990's, the durable medical equipment industry has pressed Congress and Medicare to impose provider accreditation requirements for durable medical equipment suppliers. Accreditation is one time-tested way of distinguishing legitimate businesses from fraudulent entities. While it took Congress until 2003 to pass a law mandating accreditation, it wasn't until several weeks ago that Medicare actually indicated the date by which DME suppliers must be accredited-and that date is not until September 30, 2009. Moreover, in 2006, the American Association for Homecare recommended that CMS adopt quality standards for DME that were far more stringent than those the agency actually adopted in its final standards issued in November 2006.
The American Association for Homecare (AAHomecare) represents providers of durable medical equipment and related services and supplies as well as equipment manufacturers. AAHomecare members serve the medical needs of millions of Americans who require home oxygen equipment, wheelchairs and other mobility products, hospital beds, medical supplies, inhalation drug therapy, home infusion, and other medically prescribed equipment and services delivered in the patient's home. AAHomecare's members operate more than 3,000 homecare locations in all 50 states.
American Association for Homecare
A law passed in 1997 requires a $50,000 surety bond for DME providers as a deterrent to fraud and abuse. However, the federal government has never actually implemented the surety bond requirement for the DME sector. The Centers for Medicare and Medicaid Services has proposed that the amount increase to $65,000.
The bill introduced last week, S. 2603, called the "Medicare Fraud Prevention Act of 2008," would increase the $50,000 surety bond requirement by a factor of ten. The bill would also increase civil and criminal fines for Medicare fraud and abuse. The bill is sponsored by Senators Mel Martinez (R-Fla.), John Cornyn (R-Texas), Norm Coleman (R-Minn.), Lamar Alexander (R-Tenn.), David Vitter (R-La.) and Jim DeMint (R-S.C.).
"The impact of a half-million dollar surety bond requirement would be devastating on law-abiding small providers," said Tyler J. Wilson, president of the American Association for Homecare. "This provision would put a lot of home medical equipment providers out of business without fixing the fraud and abuse problem. No one is more concerned about getting criminals out of Medicare than the homecare sector, but this is clearly a case of throwing the baby out with the bathwater. Why would the government increase the surety bond by 1000 percent before it has even implemented the original amount?"
Insurance experts say a $500,000 surety bond would require that DME providers put up collateral to back the half-million-dollar bond, on top of the $10,000 to $20,000 cost of the bond.
"The American Association for Homecare welcomes and supports efforts to eliminate Medicare fraud. The Association continues to work with federal agencies and Congress to prevent fraudulent activity in the DME sector. However, it is essential for the public and Congress to understand that the Medicare program has failed to effectively exercise its already ample authority to combat fraud and abuse," Wilson stated. "And while increased civil and criminal penalties may help thwart fraud and abuse in Medicare, we suspect that most of the people who willingly engage in such activity will not be deterred by higher penalties."
Since the early 1990's, the durable medical equipment industry has pressed Congress and Medicare to impose provider accreditation requirements for durable medical equipment suppliers. Accreditation is one time-tested way of distinguishing legitimate businesses from fraudulent entities. While it took Congress until 2003 to pass a law mandating accreditation, it wasn't until several weeks ago that Medicare actually indicated the date by which DME suppliers must be accredited-and that date is not until September 30, 2009. Moreover, in 2006, the American Association for Homecare recommended that CMS adopt quality standards for DME that were far more stringent than those the agency actually adopted in its final standards issued in November 2006.
The American Association for Homecare (AAHomecare) represents providers of durable medical equipment and related services and supplies as well as equipment manufacturers. AAHomecare members serve the medical needs of millions of Americans who require home oxygen equipment, wheelchairs and other mobility products, hospital beds, medical supplies, inhalation drug therapy, home infusion, and other medically prescribed equipment and services delivered in the patient's home. AAHomecare's members operate more than 3,000 homecare locations in all 50 states.
American Association for Homecare
Explosive Growth In Nursing Homes In China
A nursing home industry is booming in China as a rapid increase in the proportion of its elderly population forces a nationwide shift from traditional family care to institutional care, according to new research by Brown University gerontologists.
The study, led by Zhanlian Feng, assistant professor of community health, and published online in the Journal of the American Geriatrics Society, is the first systematic documentation of the growth and operation of nursing homes in Chinese cities. The demographics driving the trend, however, are better known: Experts with the U.S. Census Bureau project that China's over-65 population will rise from 8.3 percent of the population today to 22.6 percent (or 329 million people) in 2040.
Under a National Institutes of Health grant to co-author Vincent Mor, professor of medical science, Feng and colleagues at Brown, Georgia State, and Nanjing University found that the number of nursing homes in Nanjing grew from only three in 1980 to more than 140 in 2009. In Tianjin, where there are 136 nursing homes, only 11 existed before 1990. More than half of the nursing homes in the capital Beijing opened after 2000.
"Institution-based long-term care has been very rare in the country in the past," said Feng. "Even now it is still rare, but we've seen explosive growth, which is quite a phenomenon in a country where for thousands of years people have relied almost exclusively on the family for old age support."
Little oversight
As homes spring up by the score, Feng said, their operation has been subject to very little of the kind of oversight that Western nations realized decades ago was necessary - often the hard way. Part of the reason is that to this point the government is largely uninvolved in financing the sector's growth spurt.
The government encourages development of long-term care facilities in the private sector, Feng said, but its provision of limited financial subsidies for construction depends on the availability of local resources.
In what has traditionally been a command economy, more than three-fifths of 1,208 nursing homes in seven cities around the country are privately owned, and in Nanjing, more than three-quarters of the homes built in the last decade are private. Across the city, 80 percent of nursing home revenue, on average, comes from private sources. The researchers there also found that patients in privately owned nursing homes tend to be sicker than those in government-owned homes.
Decades ago in the United States, nursing homes were largely unregulated until the public became increasingly horrified by stories of abuse, neglect, and otherwise substandard care, Feng said. After several waves of regulation, most notably passage of the national nursing home reform legislation as part of the Omnibus Budget Reconciliation Act of 1987, conditions improved.
"It's quite similar in many ways to what nursing homes were like in this country, back 40 or 50 years ago, before Medicare and Medicaid," Feng said. "In the beginning, regulation was lax. Chinese policymakers can avoid these mistakes. They don't have to repeat them."
As it stood in Nanjing in 2009, however, only 31 percent of nursing homes employed a doctor and only 29 percent employed a nurse. The top administrator had a college education in only four in 10 homes. More than half the staff in the city's homes, on average, are largely untrained rural migrant workers, Feng said.
"The most urgent thing for China is to plan carefully," he said. "When I talk to officials I get the impression that officials know there is a huge challenge and that the aging wave is coming. So they say, 'Let's build more beds first. Quality? Problems? We'll worry about that later.' That worries me."
Targeted interventions
Feng said the best way to meet the population's fast-growing needs, but to meet them safely, is for the government to focus on facilities where problems are most likely to occur. That means gathering more data.
"I would recommend the government mandate the reporting of some basic facility-level information, as we've collected from facilities in Nanjing and Tianjin, on a regular basis," he said. "Then the government will be in a better position to implement targeted interventions such as focusing monitoring efforts on a small number of facilities that house much sicker than average patients yet have much lower than average staffing levels."
Notes:
In addition to Feng and Mor, other authors on the paper are Brown public health researchers Chang Liu and Mingyue Sun, Georgia State University sociologist Heying Jenny Zhan, and Nanjing University sociologist Xiaotian Feng.
The National Institutes of Health supported the study through the Fogarty International Center.
The study, led by Zhanlian Feng, assistant professor of community health, and published online in the Journal of the American Geriatrics Society, is the first systematic documentation of the growth and operation of nursing homes in Chinese cities. The demographics driving the trend, however, are better known: Experts with the U.S. Census Bureau project that China's over-65 population will rise from 8.3 percent of the population today to 22.6 percent (or 329 million people) in 2040.
Under a National Institutes of Health grant to co-author Vincent Mor, professor of medical science, Feng and colleagues at Brown, Georgia State, and Nanjing University found that the number of nursing homes in Nanjing grew from only three in 1980 to more than 140 in 2009. In Tianjin, where there are 136 nursing homes, only 11 existed before 1990. More than half of the nursing homes in the capital Beijing opened after 2000.
"Institution-based long-term care has been very rare in the country in the past," said Feng. "Even now it is still rare, but we've seen explosive growth, which is quite a phenomenon in a country where for thousands of years people have relied almost exclusively on the family for old age support."
Little oversight
As homes spring up by the score, Feng said, their operation has been subject to very little of the kind of oversight that Western nations realized decades ago was necessary - often the hard way. Part of the reason is that to this point the government is largely uninvolved in financing the sector's growth spurt.
The government encourages development of long-term care facilities in the private sector, Feng said, but its provision of limited financial subsidies for construction depends on the availability of local resources.
In what has traditionally been a command economy, more than three-fifths of 1,208 nursing homes in seven cities around the country are privately owned, and in Nanjing, more than three-quarters of the homes built in the last decade are private. Across the city, 80 percent of nursing home revenue, on average, comes from private sources. The researchers there also found that patients in privately owned nursing homes tend to be sicker than those in government-owned homes.
Decades ago in the United States, nursing homes were largely unregulated until the public became increasingly horrified by stories of abuse, neglect, and otherwise substandard care, Feng said. After several waves of regulation, most notably passage of the national nursing home reform legislation as part of the Omnibus Budget Reconciliation Act of 1987, conditions improved.
"It's quite similar in many ways to what nursing homes were like in this country, back 40 or 50 years ago, before Medicare and Medicaid," Feng said. "In the beginning, regulation was lax. Chinese policymakers can avoid these mistakes. They don't have to repeat them."
As it stood in Nanjing in 2009, however, only 31 percent of nursing homes employed a doctor and only 29 percent employed a nurse. The top administrator had a college education in only four in 10 homes. More than half the staff in the city's homes, on average, are largely untrained rural migrant workers, Feng said.
"The most urgent thing for China is to plan carefully," he said. "When I talk to officials I get the impression that officials know there is a huge challenge and that the aging wave is coming. So they say, 'Let's build more beds first. Quality? Problems? We'll worry about that later.' That worries me."
Targeted interventions
Feng said the best way to meet the population's fast-growing needs, but to meet them safely, is for the government to focus on facilities where problems are most likely to occur. That means gathering more data.
"I would recommend the government mandate the reporting of some basic facility-level information, as we've collected from facilities in Nanjing and Tianjin, on a regular basis," he said. "Then the government will be in a better position to implement targeted interventions such as focusing monitoring efforts on a small number of facilities that house much sicker than average patients yet have much lower than average staffing levels."
Notes:
In addition to Feng and Mor, other authors on the paper are Brown public health researchers Chang Liu and Mingyue Sun, Georgia State University sociologist Heying Jenny Zhan, and Nanjing University sociologist Xiaotian Feng.
The National Institutes of Health supported the study through the Fogarty International Center.
New Oral Solution Formulation Of Antiepileptic Drug Vimpat (Lacosamide) (C-V)
UCB has announced the availability of an oral solution formulation of Vimpat® (lacosamide) C-V, an antiepileptic drug (AED) for add-on treatment of partial-onset seizures in people with epilepsy age 17 years and older. Vimpat 10 mg/mL solution is now available in U.S. pharmacies.
Vimpat is now conveniently available in three formulations: oral tablets, oral solution and IV injection, ensuring that patients can maintain consistent Vimpat treatment in any clinical setting. Vimpat injection is available as an alternative for patients when oral administration is temporarily not feasible. Vimpat therapy can be initiated with either oral or IV administration, and patients can be converted between formulations - with equivalent dosing - without titration.
"Having Vimpat available as an oral solution is very good news," said Ilo E. Leppik, MD, Director, Epilepsy Research and Education Program, University of Minnesota. "There are many people for whom swallowing pills is difficult and the oral solution, which can be substituted milligram for milligram to the oral tablet, will be helpful to adults with swallowing difficulties. This will be particularly useful for elderly in nursing homes who may have gastric tubes in place."
"Bringing Vimpat to market in a third formulation spotlights UCB's commitment to providing a wide range of treatment options to people living with epilepsy," said James Zackheim, PhD, CNS Medical Director at UCB. "Long-term efficacy and safety data, and more than 50,000 global patient exposures, further strengthens Vimpat's role as an add-on therapy for the treatment of partial-onset seizures in adults."
In pivotal studies, the most common adverse reactions occurring in greater than or equal to 10 percent of Vimpat-treated patients, and greater than placebo, were dizziness, headache, nausea and diplopia.
About Vimpat Oral Solution
Vimpat oral solution 10 mg/mL is a clear, colorless to yellow or yellow-brown, strawberry-flavored liquid. It will be supplied in 465 mL PET bottles.
Vimpat oral solution does not require refrigeration and should be stored at controlled room temperature (68° to 77°F).
Vimpat oral solution should be administered with a calibrated measuring device. A household teaspoon or tablespoon is not an adequate measuring device. Healthcare providers should recommend a device that can measure and deliver the prescribed dose accurately, and provide instructions for measuring the dosage.
Vimpat oral solution contains aspartame, a source of phenylalanine. A 200 mg dose of Vimpat oral solution (equivalent to 20 mL) contains 0.32 mg of phenylalanine.
IMPORTANT SAFETY INFORMATION
Warnings and Precautions
AEDs increase the risk of suicidal behavior and ideation. Patients taking Vimpat should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.
Patients should be advised that Vimpat may cause dizziness, ataxia, and syncope. Caution is advised for patients with known cardiac conduction problems, who are taking drugs known to induce PR interval prolongation, or with severe cardiac disease. In patients with seizure disorders, Vimpat should be gradually withdrawn to minimize the potential of increased seizure frequency. Multiorgan hypersensitivity reactions have been reported with antiepileptic drugs. If this reaction is suspected, treatment with Vimpat should be discontinued.
For full prescribing information on Vimpat, visit vimpat/prescribing-information.aspx, and for more information on Vimpat, visit Vimpat.
Vimpat® is a registered trademark under license from Harris FRC Corporation.
About Epilepsy
Epilepsy is a chronic neurological disorder affecting approximately three million people in the U.S. - making it as common as breast cancer. Anyone can develop epilepsy; it occurs across all ages, races and genders. Uncontrolled seizures and medication side effects pose challenges to independent living, learning and employment, so the goal of epilepsy treatment is seizure freedom with minimal side effects. However, only half of people diagnosed will achieve seizure freedom with the first medication they try and more than one million people in the U.S. continue to experience seizures despite trying two or more antiepileptic drugs. New medications and treatments give hope to those living with uncontrolled seizures.
Vimpat is now conveniently available in three formulations: oral tablets, oral solution and IV injection, ensuring that patients can maintain consistent Vimpat treatment in any clinical setting. Vimpat injection is available as an alternative for patients when oral administration is temporarily not feasible. Vimpat therapy can be initiated with either oral or IV administration, and patients can be converted between formulations - with equivalent dosing - without titration.
"Having Vimpat available as an oral solution is very good news," said Ilo E. Leppik, MD, Director, Epilepsy Research and Education Program, University of Minnesota. "There are many people for whom swallowing pills is difficult and the oral solution, which can be substituted milligram for milligram to the oral tablet, will be helpful to adults with swallowing difficulties. This will be particularly useful for elderly in nursing homes who may have gastric tubes in place."
"Bringing Vimpat to market in a third formulation spotlights UCB's commitment to providing a wide range of treatment options to people living with epilepsy," said James Zackheim, PhD, CNS Medical Director at UCB. "Long-term efficacy and safety data, and more than 50,000 global patient exposures, further strengthens Vimpat's role as an add-on therapy for the treatment of partial-onset seizures in adults."
In pivotal studies, the most common adverse reactions occurring in greater than or equal to 10 percent of Vimpat-treated patients, and greater than placebo, were dizziness, headache, nausea and diplopia.
About Vimpat Oral Solution
Vimpat oral solution 10 mg/mL is a clear, colorless to yellow or yellow-brown, strawberry-flavored liquid. It will be supplied in 465 mL PET bottles.
Vimpat oral solution does not require refrigeration and should be stored at controlled room temperature (68° to 77°F).
Vimpat oral solution should be administered with a calibrated measuring device. A household teaspoon or tablespoon is not an adequate measuring device. Healthcare providers should recommend a device that can measure and deliver the prescribed dose accurately, and provide instructions for measuring the dosage.
Vimpat oral solution contains aspartame, a source of phenylalanine. A 200 mg dose of Vimpat oral solution (equivalent to 20 mL) contains 0.32 mg of phenylalanine.
IMPORTANT SAFETY INFORMATION
Warnings and Precautions
AEDs increase the risk of suicidal behavior and ideation. Patients taking Vimpat should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.
Patients should be advised that Vimpat may cause dizziness, ataxia, and syncope. Caution is advised for patients with known cardiac conduction problems, who are taking drugs known to induce PR interval prolongation, or with severe cardiac disease. In patients with seizure disorders, Vimpat should be gradually withdrawn to minimize the potential of increased seizure frequency. Multiorgan hypersensitivity reactions have been reported with antiepileptic drugs. If this reaction is suspected, treatment with Vimpat should be discontinued.
For full prescribing information on Vimpat, visit vimpat/prescribing-information.aspx, and for more information on Vimpat, visit Vimpat.
Vimpat® is a registered trademark under license from Harris FRC Corporation.
About Epilepsy
Epilepsy is a chronic neurological disorder affecting approximately three million people in the U.S. - making it as common as breast cancer. Anyone can develop epilepsy; it occurs across all ages, races and genders. Uncontrolled seizures and medication side effects pose challenges to independent living, learning and employment, so the goal of epilepsy treatment is seizure freedom with minimal side effects. However, only half of people diagnosed will achieve seizure freedom with the first medication they try and more than one million people in the U.S. continue to experience seizures despite trying two or more antiepileptic drugs. New medications and treatments give hope to those living with uncontrolled seizures.
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