Risk Watch e-column
October 2006
An update of risk management news, issues and items of interest
Whose Identity Is It, Anyway?
It has long been shown that rising medical costs have been expanding the uninsured rolls. But higher costs are fueling a new, equally serious problem—medical identity theft. However, the thieves in these instances are not using the personal information to fraudulently destroy the victim’s credit. Instead, they are using it to obtain free medical treatment, reports a September 25 article in the Los Angeles Times.
According to a federal study, as of 2003, there had been at least 200,000 cases of medical identity theft. In most cases, the victims were unaware of the theft.
According to the Times article, medical theft is particularly easy because so many medical personnel have access to records and patients typically don’t have to verify their identities to receive care.
Adding to the headaches of having medical bills that are not one’s own, the victim of medical identity theft is at risk of being treated based on another person’s medical history.
Even after a theft has occurred, the victims may find themselves at the mercy of the very law designed to protect their information—the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The Times notes that in many cases, victims have a difficult time accessing and correcting their records once a theft has been detected. Some hospital administrators, invoking HIPAA, refuse to release the information because another person’s medical information is now intermingled with the victimized patient’s, which then cannot be released without the consent of the thief as well.
(Source: Los Angeles Times)
Medical Instructions Are Greek to Many Patients
A September 2006 report by the National Center for Education Statistics shows that most adults only have an intermediate level of health literacy. As a result, most people have problems using health-related materials effectively.
The level of literacy was determined by giving study subjects a series of tests. Women averaged 248, and men 242 out of 500 points. According to the results, fewer than one in six people have adequate health literacy. A total of 19,000 people took the test.
Other findings from the report, “The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy”:
- Adults older than 65 had lower health literacy rates than younger age groups.
- Whites and Asians had higher health literacy than blacks, Hispanics, and Native Americans.
- Hispanics had the lowest health literacy of any group tested.
It has been found that low health literacy rates are a contributing factor to high health costs and poor medical outcomes. It is believed by researchers that if health literacy rates could be raised, then patients would do a better job of maintaining their health. To that end, the researchers concluded that insurers, drug manufacturers and doctors must improve their communication skills.
(Source: National Center for Education Statistics )
The Virtue of Wait and See
The results of a study published in the September 13 issue of The Journal of the American Medical Association (JAMA) concludes that a wait-and-see approach to treating ear infections may be preferable to an automatic prescription of antibiotics.
According to the study, more prescriptions—15 million—are written for otitis media than any other childhood ailment even though about 80% of them will clear on their own.
Reducing the use of antibiotics in children is important because over-prescription can lead to antibiotic resistance, which is a growing worldwide problem.
The study, titled “Wait-and-See Prescription for the Treatment of Acute Otitis Media,” consisted of 283 pediatric participants aged 6 months to 12 years. The patients were divided into two groups. The first group of 138 was given a prescription for antibiotics, but the parents were instructed to wait 48 hours before filling it, and then only if their child’s condition worsened. The second group of 145 was given a prescription, and the parents were instructed to fill it immediately.
Researchers found that two-thirds of the wait-and-see group did not fill their prescription, and the children recovered at the same rate as the children who took their medicine immediately. There was no significant difference between either group in terms of symptoms.
The study could help bolster the wait-and-see approach, which has been recommended by the American Academy of Pediatrics and the American Academy of Family Physicians since 2004. The academies’ guidelines recommend a wait-and-see approach for children 2 and older who have no pain to mild pain, and no high fever. It recommends that all children with ear infections be given ibuprofen or acetaminophen for pain. The JAMA study found that the wait-and-see approach could be used on children as young as 6 months.
The recommendation reverses a decades-long approach of using antibiotics to treat childhood ear infections.
Prior to antibiotic treatment, about 20% of ear infections resulted in serious complications such as mastoiditis. Antibiotics cured about 90% of infections, compared to the 80% of cases resolved without them. The 10% difference caused antibiotic treatment to become the recommended method of care.
This changed during the 1990s with the emergence of drug-resistant bacteria.
(Source: The Journal of the American Medical Association )
