Research roundup: New ethics guidelines for doctors urge cost consideration; HIV testing in teens

Jan 7 2012

Today's research comes from the Annals of Internal Medicine, the Journal of the American Medical Association, the Archives of Pediatrics and Adolescent Medicine, George Washington University and the Robert Wood Johnson Foundation.

Annals of Internal Medicine: American College of Physicians Ethics Manual -- The college released a new version of its professional guidelines and included a section about considering costs involved in treatment. "The manual is not a substitute for the experience and integrity of individual physicians, but it may serve as a reminder of the shared duties of the medical profession. ... Physicians must base their counsel on the interests of the individual patient, regardless of the insurance or medical care delivery setting. ... Physicians have a responsibility to practice effective and efficient health care and to use health care resources responsibly. Parsimonious care that utilizes the most efficient means to effectively diagnose a condition and treat a patient respects the need to use resources wisely and to help ensure that resources are equitably available" (Snyder et al., 1/3).

Journal of the American Medical Association: International Variation In And Factors Associated With Hospital Readmission After Myocardial Infarction -- Researchers examined readmission rates for heart attack patients in the United States, Canada, Australia, New Zealand and 13 European nations and found U.S. patients who had suffered a "STEMI" heart attack -- caused by a blood clot blockage in a coronary artery -- are more likely than those elsewhere to be readmitted within 30 days, a marker that U.S. officials will soon use to help gauge hospital quality and reimbursements. They write: "Significant attention has been focused on reducing acute myocardial infarction readmission rates in the United States as a means of reducing health care costs, according to the assumption that readmission is (at least in part) preventable. Our analysis shows that readmission may be preventable because rates are nearly one-third lower in other countries, suggesting that the U.S. health care system has features that can be modified to decrease readmission rates. Understanding these international differences may provide important insight into reducing such rates" (Kociol et al., 1/3)

Archives of Pediatrics and Adolescent Medicine: Association Between HIV-Related Risk Behaviors and HIV Testing Among High School Students in the United States, 2009 -- Adolescents' sexual and drug use can put them at risk of the HIV/AIDS and the age group is estimated to comprise about a tenth of the undiagnosed cases in the U.S.. The researchers analyzed data from the 2009 national Youth Risk Behavior Survey and found that "students with known additional risk factors were more likely to have been tested for HIV. However, most students, including those at higher risk for HIV, had not been tested. These findings suggest that current testing practices are falling short of making HIV testing a normal part of medical care for sexually active adolescents" (Balaji et al., 1/2).

George Washington University/Robert Wood Johnson Foundation: Constitutional Challenges Update: Florida et al. v United States Department of Health and Human Services -- This brief, from a new joint effort called Health Reform GPS, examines the four issues that the Supreme Court will consider in its review of the health law: "(1) whether Congress has the power under Article I of the Constitution to enact the coverage requirement; (2) if the coverage requirement is found unconstitutional, whether it is severable from the remainder of the ACA; (3) whether the ACA's requirement that states expand Medicaid eligibility or risk losing federal funds is unduly coercive ... and (4) whether the individual coverage requirement is a tax for purposes of the Anti-Injunction Act." The authors assert that if the individual mandate is struck down, it will have "profound implications," but the "Medicaid coercion aspect of the case may be even more far-reaching" (Rosenbaum et al., 1/4).