I-Team In-Depth

Calls To Rethink The War On Opioids

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When three 13-year-old boys were sickened by the powerful synthetic opioid fentanyl at a Hartford middle school on Jan. 13, it was a shocking reminder of the human toll of the opioid crisis. One of the boys later died and a sweep of the school surfaced 40 small plastic bags of the drug. Later that same day, dozens of people spoke out against a proposal to locate a methadone clinic on a commercial street on the New Haven-Hamden border. During the ongoing battle with COVID-19, there seems to be less attention being paid to opioid addiction, advocates say.

I-Team In-Depth

Are OB-GYN Well Visits Short-Changing Women?

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During their childbearing years, many women view their obstetrician-gynecologists as primary care physicians, seeing them for preventive health care as well as for reproductive-related issues. Several studies, including one published in 2014 in the Journal of the American Medical Association (JAMA), indicate that women may be shortchanging themselves by consulting only an OB-GYN for preventive health care visits. The national study of 63 million preventive health visits by non-pregnant women found that those “of reproductive age who see OB-GYNs only for preventive care may not be receiving the full spectrum of recommended screening and counseling.”

A number of Connecticut OB-GYNs and other women’s health care specialists said, however, that they are aware of the unique role they play, and that they make a point of addressing patients’ broader needs, especially when meeting a new patient. These needs vary, of course, depending on a woman’s lifestyle, risk factors and age. “If you’re young, in your 20s, don’t smoke and are healthy, you’re very low risk,” said Dr. Susan Richman, a Branford OB-GYN.   “What [those patients may] have is very treatable, and I’m comfortable treating them.”

The JAMA study of “well-woman” visits from 2007 to 2010 showed that while OB-GYNs generally screened for cervical and breast cancers, chlamydia and osteoporosis, general practitioners more often screened for colorectal cancer, cholesterol counts and diabetes.

Disparities

‘Communities of Care’ Model Saves $5 Million In Hospital Costs

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Connecticut has saved an estimated $5.4 million in Medicare costs since 2010 by reducing re-hospitalizations of patients through a collaborative “communities of care” model in place in 14 regions around the state, including Hartford, New Haven, Milford, Meriden and Torrington. The estimate by Qualidigm, the state’s Medicare quality improvement organization, coincides with a study in the Journal of the American Medical Association (JAMA) that showed a marked decrease in both hospitalizations and readmissions of Medicare patients in regions where quality improvement organizations (QIOs) coordinate interventions that engage community partners to improve care after discharge. Hospital clinicians and their community partners in the 14 regions of Connecticut have stepped up “to find solutions (so that) patients are benefitting from enhanced coordination among providers across the care continuum,” said Dr. Mary Cooper, vice president and chief quality officer of the Connecticut Hospital Association, which is working with Qualidigm on the “communities of care” model. Readmitting Medicare patients to the hospital within a month of discharge is a frequent—and expensive — occurrence. A new report published this week by the Robert Wood Johnson Foundation shows that hospitals and their community allies made little progress from 2008 to 2010 at reducing readmissions for elderly patients.