A post-code lottery still exists for cancer patients with “exceptional circumstances”



Researchers S. Stanley Young, Ph.D., Assistant Director of the National Institute of Statistical Sciences, Heejung Bang, Ph.D., of Cornell University and Kutluk Oktay. MD, FACOG, Professor of Obstetrics & Gynecology and Director, Division of Reproductive Medicine & Infertility Department of Obstetrics & Gynecology from New York Medical College, wrote a paper, “Cereal-Induced Gender Selection? Most

Full Post: You may not be what your mother eats

A study of patients, at the Christie Hospital, Manchester, has shown that the decision to fund patient care depends more on where the patient lives, than the patient’s health circumstances, raising public concern regarding a “postcode lottery” since each decision is made solely by the patients’ local Primary Care Trust (PCT). The findings of this study are published in a letter to Clinical Oncology.

Between July 2006 and May 2008, 102 requests for funding for patients with “exceptional circumstances” were made to a total of 27 surrounding PCTs. The funding decision was gained for 98 patients (4 awaited) and of these, 73% had their applications approved. However, while some PCTs had approval rates of 100%, others had very high rejection rates, with three of the 27 PCTs accounting for over half of all rejections.

Dr Mark Saunders, one of the authors said, “Even though the application process is the same, each PCT interprets whether they feel that a patient’s circumstances are exceptional in a different way.” He goes on to add” some patients in a clinic may get the drug they applied for, but others, with similar circumstances, do not. This has created a lot of anxiety for patients and considerable extra work for clinicians, hospitals and PCTs.”

Furthermore there was found to be a stark variance in the time it took for the PCT to respond to the application, causing further distress for the patient and family. The average time taken was 37 days; however the range was from 0-231 days.

Although this study is concentrated in Manchester, Dr. Saunders points out, “A lack of national guidelines for the application process means that these problems are likely to be encountered across the country. These results underline patients’ anxiety regarding availability of new treatments and a post-code lottery”.

If a patient cannot gain funding via the PCT, there is now the option of top-up payments for the non-approved treatment. However for many this will be an unaffordable and unrealistic option.

http://www.elsevier.com/clinonc

Link




Clinicians in the intensive care unit (ICU) often care for patients who are on several life support measures at once. When such a patient is dying and the decision is reached to withdraw life support, these clinicians may make an imperfect compromise in seeking to balance the complex needs of the patient and the patient’s

Full Post: Prolonging the withdrawal of life support in the ICU affects family satisfaction with care



Researchers from the University of New South Wales (UNSW) plan to tackle underlying problems in Australia’s health system which harm in one in ten hospital patients each year. Almost $8.5 million dollars in National Health and Medical Research Council (NHMRC) funding has just been announced for the major project by the Health Minister Nicola

Full Post: One in ten patients harmed in Australian hospitals



Total knee replacement (TKR) is a common treatment for osteoarthritis, a disease affecting more than 20 million Americans. However, the surgery poses risks and both patients and physicians must carefully assess its potential benefits and harm. Studies have shown that doctor-patient communication is correlated with outcomes and that patient satisfaction and commitment to treatment are

Full Post: Health-care providers and patients differ on views of knee replacement



The government needs to rethink its approach to NHS reforms, says UNISON, in the wake of a new damning report on the cost of commissioning and outsourcing. It should concentrate on giving NHS patients the care they need - and value for money - rather than using reforms to outsource services and ‘throw precious money

Full Post: Rethink urged on NHS outsourcing



Surgery to treat obesity could be avoided if GPs and healthcare trusts put more time and money into early stage weight management programmes, a senior clinical researcher will say today (Wednesday, 17 December, 2008). And he will say that patients suffering from obesity face a “post code lottery” when seeking access to specialist care. Speaking

Full Post: GPs ‘could do more’ to help obese avoid surgery