PHARMACY

HHS data: Uninsured patients accounted for one-fifth of hospital-based emergency visits in 2006

BY Antoinette Alexander

WASHINGTON New data released by HHS Secretary Kathleen Sebelius indicated that uninsured patients accounted for nearly one-fifth of the 120 million hospital-based emergency visits in 2006.

“Our healthcare system has forced too many uninsured Americans to depend on the emergency room for the care they need,” stated Sebelius. “We cannot wait for reform that gives all Americans the high-quality, affordable care they need and helps prevent illnesses from turning into emergences.”

The data, released on Wednesday, is from the Nationwide Emergency Department Sample, the largest, all-payer emergency department database in the United States. The database is managed by HHS’ Agency for Healthcare Research and Quality and generates national estimates on the number of emergency department visits in all community hospitals, by region, urban/rural location, teaching status, ownership and trauma designation. It also provides in-depth information on acute management of patients for all visits, including why patients were seen in the emergency department, the treatments they received, what happened to them at the end of the visit, the charge for the visit and who was billed.

The National Emergency Department Sample contains 26 million records from emergency department visits from roughly 1,000 community hospitals nationwide. This represents 20% of all U.S. hospital emergency departments.

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PHARMACY

H.D. Smith elevates sales, purchasing leaders

BY Jim Frederick

SPRINGFIELD, Ill. Pharmacy wholesaler H.D. Smith has promoted two veteran executives in a continuing bid to strengthen its senior management ranks and boost its growth potential.

The latest moves include the promotion of Jeff Greer to VP sales and Bob Dynek Jr. to VP purchasing and trade relations.Greer, who joined the company in 2005 after long service with drug wholesale giant AmerisourceBergen, will lead an effort by H.D. Smith to expand into new service sectors. Dynek, an 11-year company veteran whose previous career included stints with General Drug Co., Foxmeyer Corp. and Louis Zahn Drug Co., will will have primary responsibility for purchasing and managing inventory service levels across all business segments.

“Moving Jeff and Bob into corporate headquarters will take full advantage of growth potential for the company,” said Dale Smith, chairman and CEO. “Together, they bring more than 50 years of expertise in pharmacy distribution and will be influential in helping us realize our goal of becoming the preferred pharmaceutical wholesaler nationwide.”

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Diabetes not sole cause of depression in diabetic patients, study suggests

BY Anna Mcgrath

NEW YORK Increased risk of depression in diabetic patients could be the result of more frequent contacts with the medical system, rather than the disease itself, a new study suggested.

Previous research suggested that diabetic individuals faced a higher risk of depression, yet few studies accounted for the number of primary care visits that patients make, noted Patrick O’Connor of HealthPartners Research Foundation in Bloomington, Minn., and his colleagues.

To investigate, O’Connor and his colleagues analyzed records from a large medical group that treated about 225,000 patients between 1997 and 2003 and found that the likelihood of being newly diagnosed with depression fell as the number of times the patient visited the doctor increased.

Among the group of diabetic patients with few physician visits during the study period were 46% more likely to be newly diagnosed with depression during the course of the study. But for the diabetic patients who had more than 10 physician visits during the study period, the risk of a new depression diagnosis was similar to that of non-diabetic individuals who visited their physicians equally often.

The reason why people — diabetic or not — who visit the doctor less often are more likely to be depressed isn’t clear, the researchers said. “These data might indicate that primary care clinicians are good at recognizing depression after only a few visits,” they wrote. “Other explanations are possible, however; perhaps physician who do not recognize depression early are not likely to diagnose it later.”

This study was published in Annals of Family Medicine, July/August 2009.

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