The report, â€œChronic Conditions Account for Rise in Medicare Spending from 1987 to 2006,â€ was published Feb. 18 by the journal Health Affairs.
Kenneth E. Thorpe, PhD
Thorpe and colleagues analyzed data about disease prevalence and about level of and change in spending on the 10 most expensive conditions in the Medicare population from 1987, 1997 and 2006.
Among key study findings:
Heart disease ranked first in terms of share of growth from 1987 to 1997.Â However, from 1997 to 2006, heart disease fell to 10th, while other medical conditions â€“ diabetes the most prevalent â€“ accounted for a significant portion of the rise.
Increased spending on diabetes and some other conditions results from rising incidence of these diseases, not increased screening and diagnoses.
What a cancer patient wants to know after surgery can be expressed succinctly: “Did you get everything?” Having a confident answer to that question can be difficult, because when they originate or metastasize, tumors are microscopic.
Considerable advances have been made in “targeted therapy” for cancer, but the wealth of information available on the molecular characteristics of cancer cells hasn’t given doctors good tools for detecting cancer during surgery – yet.
Even the much-heralded advent of robotic surgery has not led to clear benefits for prostate cancer patients in the area of long-term cancer control, a recent New York Times article reports.
At Emory and Georgia Tech’s joint department for biomedical engineering, Shuming Nie and his colleagues are developing tools that could help surgeons define tumor margins in human patients.
The palliative care program at Emory University is working to improve quality of life and wellness by addressing the physical, psychological, ethical, spiritual and social needs of patients with serious, life-threatening or progressive chronic illnesses, and provides support to their families and caregivers.
Tammie E. Quest, MD
Often mistakenly confused with hospice care, palliative care is appropriately provided to patients in any stage of serious illness – whereas hospice care is primarily used for those approaching the end stage of life, says Tammie Quest, MD, interim director of the Emory Center for Palliative Care.
A typical palliative care “team” consists of physicians, nurses, social workers, chaplains, mental health professionals, therapists and pharmacists, assisting patients through a wide array of illnesses, including stroke, heart and lung disease, cancer and HIV.
The palliative care teams work closely with primary physicians to control pain, relieve symptoms of illnesses – such as nausea, fatigue and depression. Teams help provide counseling in making difficult medical decisions and provide emotional and spiritual support, coordinate home care referrals and assist with identifying future care needs.
Vivian Pinn, MD, associate director for research on womenâ€™s health, and director of the Office of Research on Womenâ€™s Health at NIH, opened the meeting with Emoryâ€™s conference chair, Nanette Wenger, MD, professor of medicine (cardiology), Emory School of Medicine, and chief of cardiology at Grady Memorial Hospital.
Nanette K. Wenger, MD
In a career that spans more than 50 years, Wengerâ€™s dedication to reducing womenâ€™s disability and death from cardiovascular disease has made her one of the countryâ€™s most-respected experts on coronary heart disease in women. In 2009, Wenger received the Lifetime Achievement Award from the American College of Cardiology.
Although Wenger has earned dozens of awards in her celebrated career, she says her greatest professional achievement has been to help change a major paradigm in cardiology: the assumption that heart disease affects only men. A half a century ago heart disease was thought of as a “man’s disease.”
At Emory’s fifth annual predictive health symposium â€œHuman Health: Molecules to Mankind,â€ Emory GYN/OB Sarah L. Berga, MD, discussed the state of childbirth in the United States and how maternal stress affects pregnant women and their fetuses.
Berga is McCord professor and chair of the Department of Gynecology and Obstetrics at Emory School of Medicine. Sadly, BergaÂ has seen maternal mortality rise steadily since the 1980s when she entered her medical residency. Georgia, she says, has the worse maternal mortality in the country. And the United States fares worse than many countries when it comes to maternal mortality.
Despite the unfortunate rise in maternal mortality of late, the good news is physicians have now started to pay more attention to the effect of stressâ€”both the physical and emotional kindâ€”on women and their fetuses. Recent research shows stress has the same negative effect on the body as do organic diseases, such as thyroid disease. In fact, too much stress reduces thyroxine levels by about 50 percent, says Berga. But because thereâ€™s no clinical recognition of this, tests are needed to determine if thyroxine levels are indeed insufficient.
Pathologist Keqiang Ye has made a series of discoveries recently, arising from his investigations of substances that can mimic the growth factor BDNF (brain-derived neurotrophic factor).
BDNF is a protein produced by the brain that pushes neurons to withstand stress and make new connections. Some neuroscientists have described BDNF as “Miracle Gro for brain cells.”
â€œBDNF has been studied extensively for its ability to protect neurons vulnerable to degeneration in several diseases, such as ALS, Parkinsonâ€™s and Alzheimerâ€™s disease,â€ Ye says. â€œThe trouble with BDNF is one of delivery. Itâ€™s a protein, so it canâ€™t cross the blood-brain barrier and degrades quickly.â€
Working with Ye, postdoctoral fellow Sung-Wuk Jang identified a compound called 7,8-dihydroxyflavone that can duplicate BDNFâ€™s effects on neurons and can protect them against damage in animal models of seizure, stroke and Parkinsonâ€™s disease. The compoundâ€™s selective effects suggest that it could be the founder of a new class of brain-protecting drugs. The results were published in Proceedings of the National Academy of Sciences.
Long before a 7.0-magnitude earthquake ravaged Haiti, a mother-daughter-daughter trio of Emory’s Nell Hodgson Woodruff School of Nursing graduates was already working in Haiti to help thousands of orphaned children there.
Cheron Hardy (03MN) joined the staff of the nonprofit Eternal Hope in Haiti (EHIH) shortly after graduating from Emoryâ€™s Nell Hodgson Woodruff School of Nursing. EHIH was formed in 1993 by nursing alumna Twilla Haynes (80MN) and her daughters, Angela Haynes (91PH, 08N, 09MN) and Hope Haynes Bussewius (93MN).
In 1993, Twilla Haynes (80MN), of Hoschton, Ga. â€“ with the help of her daughters, Angela Haynes (91PH, 08N, 09MN) and Hope Haynes Bussewius (93MN) â€“ founded Eternal Hope in Haiti (EHIH), an organization dedicated to better health care for Haitiâ€™s people. Three years later, they opened the Hope Haven Orphanage in Cap Haitien in the northwest province of Haiti.
In many countries, taxes on tobacco have successfully reduced its consumption. As world leaders in countries consider raising the excise tax on tobacco products in the coming year, it is vital they consider all the determinants that effectively promote health through taxation, say Emory global health experts Jeffrey Koplan, MD, MPH, and Mohammed Ali, MBChB, MSc.
Over the past few weeks, more than 150 Emory University faculty, staff and students, as well as Emory Healthcare staff, have volunteered with Atlanta-based MedShare, sorting thousands of medical supplies that are being shipped to medical personnel on the ground in Haiti.
Volunteering for Haiti relief
Patricia Guasch, RN, director of Emory University Hospitalâ€™s rehabilitation nursing services, is one of the many Emory MedShare volunteers lending a hand in the relief effort. Guasch and several of her colleagues from the Emory Center for Rehabilitation Medicine, along with their children, spent the King Holiday weekend sorting supplies at MedShare.
You may have already heard that last month Emory held its fifth annual predictive health symposium â€œHuman Health: Molecules to Mankind.â€ Researchers, physicians, health care workers and members of the community from throughout the country met to learn about intriguing research and provocative commentary by health care experts.
One of those experts, Paul Wolpe,Â director of the Emory Center for Ethics,Â says health care has changed as more and more aspects of ordinary life or behaviors are being redefined as medical. For example, being drunk and disorderly has become alcoholism. Now, virtually all of life is being redefined in biological terms, he says. And that, says Wolpe, has led to an increase in health care costs. We have an enormous amount of new things that we are calling illness, and we expect our health care system to treat them, he says. â€œWe are creating a new category of disease called pre-symptomatic.â€