CDC: Obesity prevalence down among 2- to 5-year-olds
ATLANTA — The latest obesity data from the Centers for Disease Control and Prevention, published in the Feb. 26 issue of the Journal of the American Medical Association, showed a significant decline in obesity among children aged 2 to 5 years. Obesity prevalence for this age group went from nearly 14% in 2003-2004 to just more than 8% in 2011-2012 — a decline of 43% — based on CDC’s National Health and Nutrition Examination Survey data.
Although the JAMA study does not specifically compare 2009-2010 with 2011-2012, NHANES data does show a decline in the 2- to 5-year-old age group during that time period — from just more than 12% in 2009-2010 to just more than 8% in 2011-2012.
“We continue to see signs that, for some children in this country, the scales are tipping. This report comes on the heels of previous CDC data that found a significant decline in obesity prevalence among low-income children ages 2 years to 4 years participating in federal nutrition programs,” stated CDC director Tom Frieden. “We’ve also seen signs from communities around the country with obesity prevention programs, including Anchorage, Alaska, Philadelphia, New York City and King County, Wash. This confirms that at least for kids, we can turn the tide and begin to reverse the obesity epidemic.”
While the precise reasons for the decline in obesity among 2- to 5-year-olds were not clear, many child care centers have started to improve their nutrition and physical activity standards over the past few years. In addition, CDC data show decreases in consumption of sugar-sweetened beverages among youth in recent years. Another possible factor might be the improvement in breastfeeding rates in the United States, which is beneficial to staving off obesity in breastfed children.
“I am thrilled at the progress we’ve made over the last few years in obesity rates among our youngest Americans,” stated Michelle Obama, First Lady of the United States of America. “With the participation of kids, parents and communities in Let’s Move! these last four years, healthier habits are beginning to become the new norm.”
Overall, CDC’s latest NHANES obesity data published in this week’s issue of the Journal of the American Medical Association indicated there had been no significant changes in obesity prevalence among 2- to 19-year-olds or adults in the United States between 2003-2004 and 2011-2012.
Study: ‘Medical homes’ yield limited quality improvement, no cost containment
NEW YORK — A three-year pilot of a “medical home” model of primary care yielded few improvements in quality and cost of health care, according to a new Rand study.
Evaluating one of the nation’s earliest and largest multi-payer medical home pilots, researchers found that most participating primary care practices achieved recognition as medical homes, but the quality of care improved significantly for only 1-of-11 widely used quality measures.
The findings are published in the Feb. 26 edition of the Journal of the American Medical Association.
“The medical home has gained popularity as a new model of primary care, with the expectation that the approach will produce better and lower-cost health care,” stated Mark Friedberg, the study’s lead author and a natural scientist at Rand, a nonprofit research organization. “Our findings suggest that achieving all of these goals is a challenge.”
Medical homes, also known as “patient-centered medical homes,” are primary care practices that are designed to provide comprehensive, personalized, team-based care using patient registries, electronic health records and other advanced capabilities. Recent medical home initiatives have encouraged primary care practices to invest in these new capabilities, participate in learning collaboratives and achieve medical home recognition. Health plans offer to pay more to the practices that achieve recognition.
Comprehensive primary care can improve outcomes for chronic conditions like diabetes and asthma, while lowering costs by reducing patients’ needs for care from hospitals and emergency departments.
Researchers evaluated the Southeastern Pennsylvania Chronic Care Initiative, which was the first of several regional multi-payer medical home pilots in the state. In this region, 32 primary care practices and six health plans participated in the pilot between 2008 and 2011.
Using data on approximately 120,000 patients, researchers compared quality, utilization and costs of care between the pilot practices and 29 other practices that were not in the pilot.
The study found that pilot practices successfully adopted the medical home capabilities, such as creating lists of patients overdue for needed services, and achieved recognition as a medical home from the National Committee on Quality Assurance. Rates of monitoring for kidney disease among patients with diabetes improved, and there were signs that quality improved for some other aspects of diabetes care.
However, the evaluation of the medical home pilot did not detect improvements on the quality measures that assessed asthma care, cancer screening and control of diabetes, according to researchers.
In addition, the medical home pilot did not show a reduction in patients’ use of hospitals or emergency departments, or the total costs of medical care.
“It is possible that the pilot we evaluated had some, but not all of the ingredients necessary to produce broad improvements in quality and efficiency,” Friedberg stated. “Findings from this evaluation and others should help refine the medical home model.”
Researchers indicate that there are several possible reasons that the pilot medical home pilot did not show broader improvements on measures of cost and quality.
The pilot emphasized quality of care for diabetes and asthma, and practices did not have financial incentives to contain costs. While most participating practices adopted new capabilities that targeted quality of care, fewer increased night and weekend hours, which could have created short-term savings by reducing unnecessary visits to hospital emergency departments.
Because the pilot practices volunteered to become part of the medical home experiment, they may have been more quality-conscious than other practices even before the pilot began. This would have created a “ceiling effect” where there was less room to improve quality, according to researchers.
Rand researchers also are conducting evaluations of several additional medical home primary care pilot projects, including other regions of the Pennsylvania Chronic Care Initiative.
The Commonwealth Fund and Aetna supported the study.
Hy-Vee, MU Health Care to open Mizzou Quick Care Clinics
COLUMBIA, Mo. — The University of Missouri Health Care and grocer Hy-Vee have announced plans to open walk-in medical clinics at all three Hy-Vee stores in Columbia, Mo. Construction of the Mizzou Quick Care clinics will begin in mid-March.
The clinics at 25 Conley Road and 405 E. Nifong Blvd. are slated to open by Aug. 1, and the clinic at 3100 W. Broadway is slated for completion by Oct.1.
"Mizzou Quick Care will provide convenient, affordable, walk-in medical care to anyone in the community age 1 year or older with a common illness, such as an ear infection, strep throat or the flu," stated Mitch Wasden, CEO and COO of MU Health Care.
"Convenient, affordable, quality primary care is in keeping with our mission to advance the health of our community," he added. "The Mizzou Quick Care clinics will be linked to all MU Health Care providers through the health system’s advanced electronic health record, and the providers at Mizzou Quick Care will be able to facilitate access to higher-level care for those in need."
Susan Pereira will serve as medical director of the Mizzou Quick Care clinics. Pereira is a family medicine physician at MU Health Care, as well as an associate professor in the Department of Family and Community Medicine at the MU School of Medicine.
"We have an opportunity and responsibility to our customers to help them meet all their health-and-wellness goals," stated Andy McCann, chief health officer for Hy-Vee. "Partnering with University of Missouri Health Care to offer quick and convenient clinical services in our Columbia stores for minor ailments is just one more way we accomplish that goal."
Mizzou Quick Care clinics will serve patients with upper respiratory symptoms like sore throat or cough, urinary symptoms, skin rashes and minor injuries. The clinics also will offer employment-screening physicals and daycare physicals, pregnancy tests, sports physicals, flu shots and limited adult immunizations.