A genetic test that helps doctors determine how best to treat breast cancer—and whether chemotherapy is likely to help—is significantly more likely to be administered to white women than blacks or Hispanics, a Yale study has found. The test, called Oncotype Dx (ODx), uses gene expression to gauge how early-stage breast cancer is affecting patients’ gene activity. It uses the information to determine how likely cancer recurrence would be, and physicians and their patients can use that knowledge to decide how to proceed with treatment. Yale researchers retrospectively analyzed a group of more than 8,000 Connecticut women who were diagnosed with hormone receptor positive breast cancer between 2011 and 2013, and found “significant racial and ethnic disparities in use of this new gene test,” said study leader Dr. Cary Gross, a member of Yale Cancer Center and professor of medicine and epidemiology at Yale School of Medicine. “It reinforces that, at the same time we are investing in developing new treatments and new testing strategies and we’re promoting them with great excitement, we really need to double-down our efforts to eliminate disparity,” Gross said.
Low-income women in Connecticut who have just given birth and know they don’t want to get pregnant again anytime soon are now offered a long-acting birth control option postpartum. Medical providers say the policy by the U.S. Department of Health and Human Services will reduce the number of unplanned pregnancies, as well as lead to better maternal health outcomes by ensuring pregnancies are spaced a healthy length of time apart. Connecticut’s HUSKY program is one of 26 state Medicaid programs nationwide that reimburses hospitals for administering long-acting reversible contraception (LARC)—namely, intrauterine devices (IUDs) and subdermal implants—to Medicaid patients. HUSKY started reimbursing for the devices last year. “It’s a great thing,” said Dr. Elizabeth Purcell, an obstetrician and gynecologist practicing in Hartford.
Reported cases of tuberculosis jumped 17 percent in Connecticut from 2014 to 2015, mirroring a national and global trend and prompting federal officials to ask primary care providers to be on the alert for at-risk patients. The state Department of Public Health (DPH) said 70 people, in 29 towns, were reported with active TB, the contagious form of the disease, in 2015, compared with 60 the year before. About 80 percent of Connecticut patients were foreign-born, many from Asian countries. Nationally, TB cases totaled 9,563 last year, an increase of 157 over 2014. It was the first jump in cases after more than two decades of annual declines, the U.S. Centers for Disease Control and Prevention (CDC) reported.
Clattering carts, overly bright lights and frequent disruptions make hospitals a tough place to get a good night’s sleep. But now, hospitals across Connecticut are launching efforts to help patients sleep longer and better. At Yale-New Haven Hospital, researchers are expanding a pilot program that successfully reduced noise in the medical ICU and kept staff out of patient rooms overnight. At Hartford Hospital, where noise levels sometimes resembled airport runways, they’ve eliminated overhead paging on patient floors except in true emergencies. And Stamford Health’s new hospital building, slated to open in September, is designed with sleep in mind.
Eighteen Connecticut hospitals will lose 1 percent of their Medicare payments in 2016 as a penalty for comparatively high rates of avoidable infections and other complications, such as pressure sores and post-operative blood clots, according to new federal data. The Centers for Medicare & Medicaid Services (CMS) announced this month that 758 of the nation’s hospitals – about 23 percent of all eligible hospitals — would be penalized for patient safety lapses in the second year of the Hospital-Acquired Condition Reduction Program, which was mandated by federal health care reform. The penalties are based on rates of infections and other complications that occurred in hospitals between 2012 and 2014. The 18 hospitals in Connecticut include larger urban institutions, such as Yale-New Haven, Hartford and Bridgeport hospitals, and smaller hospitals, such as Manchester Memorial and Windham. They are among hospitals in the worst performing quartile nationally on patient-safety measures including the frequency of central-line and catheter-related infections, post-operative sepsis and accidental laceration.
All but one of Connecticut’s acute-care hospitals will lose Medicare reimbursement in 2015-16 as a penalty for high readmissions of discharged patients, new federal data show. The penalties against 28 hospitals mean Connecticut has one of the highest percentages nationally – more than 90 percent — of hospitals facing Medicare reductions. Only the Hebrew Home and Hospital of West Hartford escaped penalties; the Connecticut Children’s Medical Center is exempted from the federal program. None of the state’s hospitals faces the maximum 3 percent reduction to Medicare reimbursement, but seven face reductions of more than 1 percent. They are: Milford Hospital (1.70 percent); Middlesex, in Middletown (1.38); Johnson Memorial, in Stafford Springs (1.27); Charlotte Hungerford, in Torrington (1.19); St.
Women trying to combat high blood pressure may have a new weapon in their arsenal: blueberries. Daily consumption of blueberries has been shown to lower blood pressure and lessen arterial stiffness in post-menopausal women, according to a new clinical trial. The trial, which took place in Florida and recently was published in The Journal of the Academy of Nutrition and Dietetics, examined the effects the fruit had on 48 women. Post-menopausal women provided a meaningful test group, according to study authors, because they typically are more likely than others to have hypertension, or high blood pressure, and to develop arterial stiffness, which increases their risk for cardiovascular disease. Over the course of eight weeks, the women were randomly assigned to take either 22 grams of freeze-dried blueberry powder, which equals about a cup of fresh blueberries, or 22 grams of a placebo powder.
Connecticut’s diabetes rate ranks lower than the national average, but Hispanics and African-Americans are more than twice as likely to have the disease compared with their white neighbors and are at greater risk of dying from diabetes-related causes. Approximately 250,000 Connecticut adults (8 percent) have been diagnosed with Type 2 diabetes and an estimated 83,000 state residents don’t realize they have the disease, according to 2011-13 data from the U.S. Centers for Disease Control and Prevention (CDC). Nationally, 29.1 million people (9.3 percent) have diabetes and 8.1 million people don’t know they have the disease, reports the CDC. Connecticut’s Hispanics (14.6 percent) and African-Americans (14.1 percent) have significantly higher rates of diabetes than whites (6.7 percent). In addition, adults with annual household incomes below $25,000 are 2.3 times more likely to have diagnosed diabetes compared with adults with household incomes over $75,000, according to the CDC.
Connecticut’s acute-care hospitals saw gains from their operations tumble 35 percent in the last fiscal year, with seven of 29 hospitals reporting operating losses, according to a new state report. While hospitals still ended the year with $597 million in profits overall, the report by the state Office of Health Care Access (OHCA) raises concerns that non-operating revenue, such as income from investments, was masking the decline in operating revenue. “While hospitals’ operational financial performance weakened in FY 2013, they continued to generate significant non-operating gains, helping to keep overall hospital financial performance strong,” the report says. “However, a robust financial picture should rely more on patient and other operating revenues, and not on a less than reliable income source, such as investment performance.”
Hospitals’ profits from operations dropped to $333.6 million, from $513.5 million in the 2012 fiscal year. At the same time, hospitals earned $70 million more from investments, charitable contributions and other sources of revenue.
State health inspectors visiting Stamford Hospital in late 2012 turned up several infection-control violations, including the improper drying and storage of endoscopes, instruments used to look inside the body. An inspection of Hartford Hospital in 2012 found an operating room with “dust and darkened debris” on top of pumps attached to IV poles, a container of syringes “overflowing” a protective cover, and brownish stains on the floor and underside of the operating table. These kinds of lapses, while not directly tied to patient infections, have contributed to Connecticut’s poor ratings on some federal measures of hospital-acquired infections. Newly released data show that more than 50 percent of the state’s hospitals had rates for at least one type of hospital-acquired infection that were worse than federal benchmarks, in late 2012 and 2013. No other state had a higher percentage of its hospitals exceeding the infection standards set by the U.S. Centers for Disease Control and Prevention, and most states had fewer than 20 percent, according to the data, compiled by Kaiser Health News.