UK - Quality of Life and Experience of Care in Women With Metastatic Breast Cancer: A Cross-Sectional Survey

Blogger's Comment: read prior post on 'symptom clusters'

Journal of Pain and Symptom Management - Quality of Life and Experience of Care in Women With Metastatic Breast Cancer: A Cross-Sectional Survey

Conclusion

Despite improvements in treatment and survival of women with metastatic breast cancer, this group reports high symptom burden and dissatisfaction with elements of their care, indicating that alternative models of service delivery should be explored.

ScienceDirect.com - Journal of Pain and Symptom Management - Talking About End-of-Life Preferences With Advanced Cancer Patients: Factors Influencing Feasibility

ScienceDirect.com - Journal of Pain and Symptom Management - Talking About End-of-Life Preferences With Advanced Cancer Patients: Factors Influencing Feasibility

Conclusion

Results indicate that discussing end-of-life preferences in an earlier disease phase, such as in the OU (outpatient) setting, could be preferable but that its accomplishment in this setting may be more difficult, mainly as a result of organizational reasons. This observation could indicate that the system is not yet ready to offer patients such an opportunity and although communication on these sensitive issues cannot be reduced to a procedure, the ELPI can become a useful tool to help physicians in accomplishing this difficult task.

[Comment] Offline: Is CDC a science-based organisation? The Lancet

[Comment] Offline: Is CDC a science-based organisation?:

"When we published our first report describing discontent about the work of the Center for Global Health (CGH) at the US Centers for Disease Control and Prevention, CDC immediately contacted us to ask for an opportunity to reply. We agreed and await their response. Meanwhile, two further letters have arrived. They again signal severe concerns about the way in which CDC organises its global health work. Both correspondents are well informed about the details of the CDC's work in global health. Their allegations are serious." (subscription required $$$)

PCORI Paddles the Potomac (healthcare systems/dysfunction....)

By Merrill Goozner
Merrill Goozner has been writing about economics and health care for many years. The former chief economics correspondent for the Chicago Tribune, Merrill has written for a long list of publications including the New York Times, The American Prospect, The Washington Post and The Fiscal Times. You can read more pieces by him at GoozNews.

PCORI Paddles the Potomac:

Cynics say Washington is the city where good ideas go to die. A promising strategy for holding down health care costs in the Obama administration’s reform bill – providing patients and doctors with authoritative information on what works best in health care – should provide a classic test of that proposition, assuming the law survives the next election.
Experts estimate anywhere from 10 to 30 percent of the health care that Americans receive is wasted. It is either ineffective or does more harm than good. To put that in perspective, waste costs anywhere from $250 billion and $750 billion a year, or as much as three-fourths of the annual federal deficit.
Yet every effort to curb wasteful spending (health care fraud, though pervasive, is estimated at less than a quarter of the total) has come up short.

open access: Impact of remuneration and organizational factors on completing preventive manoeuvres in primary care practices

Blogger's Note: note patient numbers per physician; study limitations

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"Primary care providers are increasingly interested in ensuring that preventive health care be part of their work routines.1 This reorientation fits with the evidence that recommendations from family practitioners increase substantially the likelihood of patients undergoing preventive manoeuvres,2 whereas the lack of such recommendations has been linked with patient noncompliance.3^,4

Studies evaluating adherence to recommended preventive care suggest that the most pervasive barriers rest with the organization of the health care system and the practice itself, such as the absence of external financial incentives for the work done and the lack of a reminder system in the office.3^,5^–9

Countries attempting to reform their delivery of primary care and improve the delivery of preventive services have often directed their efforts in finding alternatives to the traditional fee-for-service model, in which providers receive payment for each service provided......."