Medical Care

Caring for patients with multiple chronic conditions -- New research and future challenges
The millions of Americans living with more than one chronic disease are at high risk of poor health outcomes, and account for a disproportionate share of health care costs. A special March supplement to Medical Care presents updates from the Agency for Healthcare Research and Quality's (AHRQ) Multiple Chronic Conditions (MCC) Research Network, formed to address knowledge gaps and research challenges in meeting the complex health care needs of this growing population. Eurekalert! 

Computerized checklist reduces type of hospital infection, Stanford/Packard study finds
The automated checklist, and a dashboard-style interface used to interact with it, made it fast and easy for caregivers to follow national guidelines for keeping patients' central lines infection-free. The new system combed through data in the electronic medical record and pushed alerts to physicians and nurses when a patient's central line was due for care. During the study, the rate of central line infections in the hospital's pediatric intensive care unit dropped from 2.6 to 0.7 per 1,000 days of central line use. The findings will be published online Feb. 23 in Pediatrics. Eurekalert! 

Almost No Benefit of Medical Home Interventions in Community-Based Practices
The patient-centered medical home approach to primary care did little to improve utilization or quality-of-care measures in a JAMA study. Thirty-two primary care practices in Pennsylvania who adopted a wide range of medical home features (e.g., performance feedback, disease-management registries) were compared with 29 control practices. Intervention practices achieved "medical home-ness" by the end of the 3-year study, as measured by standardized national criteria.

By study's end, intervention and control practices did not differ in ambulatory care-sensitive hospitalizations, emergency department use, primary care or specialist visits, or total cost of care. Only 1 of 11 quality-of-care measures (monitoring for diabetic nephropathy) was better in intervention practices. Journal Watch

Personalized medicine has finally arrived -- or has it?
As the price for decoding a person's DNA keeps dropping, expectations for personalized medicine based on specific genetic profiling rise. But translating an individual's genetic data into finely tailored medical treatments still faces major challenges, explains a new article in Chemical & Engineering News (C&EN), the weekly magazine of the American Chemical Society. Eurekalert!