(HealthDay News) -- More than three-quarters of adult Americans who have health insurance say they still worry about paying more for their medical care, and nearly 50 percent say they're "very" or "extremely" worried about the issue, a new Harris Interactive/HealthDay poll shows.
More than half (57 percent) of those polled said they feared losing their health insurance sometime in the future, which may explain another key finding in the poll -- sizeable numbers of Americans said they're skipping doctor visits or not getting prescriptions filled to save money.
Middle-aged Americans -- people too old to be blasé about their health but too young to be covered by Medicare -- seemed most worried about paying their health care bills. Among insured individuals aged 45 to 64, a full 84 percent said they were concerned that rising health care costs would exceed their ability to pay.
Only 8 percent of all insured Americans polled were "not at all worried" about getting health care coverage.
"Many are, in fact, not filling prescriptions, skipping a doctor's visit, not following up on something that was recommended by the doctor, taking a medication less or pill-splitting, doing without dental care," said Humphrey Taylor, chairman of The Harris Poll.
He added that with the economy in a tailspin and many Americans losing their employer-based health insurance, the problem may only get worse. "If the number of uninsured rises sharply, one would expect to see these numbers increase," Taylor said.
One consumer advocate wasn't surprised by the results of the poll, which included 2,078 adults surveyed between Feb. 25 and 27.
"Even for people who have insurance, increasingly, the costs have been shifted to them -- and those costs have risen," said Carol Pryor, policy director at The Access Project, a nonprofit group dedicated to making health care available to more Americans. More and more, she added, insured Americans are paying higher deductibles and co-pays, stretching their ability to get proper medical care.
Pryor agreed with Taylor that the situation is only likely to get worse, since "more people are becoming uninsured as a result of the economic meltdown."
Some other key findings from the poll:
78 percent of adults with health insurance worry about paying more for their medical care.
Nearly two-thirds (65 percent) of all insured adults say they're worried about how they can afford to pay for medical care and prescription drugs, with that number rising to 76 percent among people aged 45 to 54. Even among those aged 65 and over -- most of whom are eligible for Medicare -- 62 percent say they worry about paying for the care they need.
Over the past year, one in five insured adults skipped filling a prescription because of the cost. That number jumped to 30 percent for those without insurance.
Similarly, cost concerns led 24 percent of the insured and 51 percent of the uninsured to forgo seeing a doctor for a specific medical problem. Twenty-one percent of the insured and 33 percent of the uninsured didn't get a recommended follow-up test or treatment for the same reason.
Trying to cut down on medical expenses, 14 percent of the insured and 19 percent of the uninsured took a medication at a lower dose than that recommended by a doctor.
Dental care took the biggest hit: 51 percent of the uninsured and 30 percent of the insured skipped necessary dental care over the past year due to financial concerns.
Forgoing care to save costs over the short term may not save costs over the long term, the experts warned. "Some things do go away on their own over time," Pryor said. "But there are a lot of conditions that get worse if they aren't treated, and they then require more expensive care later. So it's definitely a gamble."
Taylor noted that the statistics on the percentage of Americans skipping needed care have remained about the same since 2007, when Harris first asked these types of questions. That may seem odd given the recent downturn in the economy, he added. But, he noted that even if a few million Americans lose their health insurance, that's still only 2 percent of the adult population -- not enough to show up in this type of survey.
The new poll results come on the heels of a report released Wednesday by the nonprofit advocacy group Families USA. It found that a third of Americans under the age of 65 -- nearly 87 million people -- went without health care coverage at some point over the past two years.
The most recent U.S. government statistics suggest that 16 percent of all adults (including those 65 and older) have no health insurance. And a Commonwealth Fund report published last June found that the number of "underinsured" -- people who have insurance that doesn't fully meet their health care needs -- rose by 60 percent between 2003 and 2007.
The issue gained momentum in the nation's capitol last Thursday, when President Barack Obama convened a long-anticipated White House summit on health care reform. The Associated Press reported that Obama made a point of bringing a wide range of views to the table -- voices representing the insurance industry, patient groups, physicians and even those advocating a single-payer system.
"Every voice has to be heard. Every idea must be considered," Obama said during the summit. "The status quo is the one option that is not on the table."
According to Pryor, one item that should be up for discussion in Washington is the plight of the underinsured.
"Covering the uninsured is only part of the problem," she said. "Unless reform includes adequate, comprehensive and affordable coverage, just having insurance will not be protection -- either from facing barriers to care or concern over one's financial stability. And after all, those two things are the function of insurance."
More information
There's more on the underinsured in America at The Commonwealth Fund.
Selasa, 10 Maret 2009
Jumat, 06 Maret 2009
Health Tip: Understanding Antibiotic Resistance
(HealthDay News) -- Antibiotic resistance occurs when bacteria mutate and make certain medications ineffective in preventing bacterial infections.
The U.S. Department of Health and Human Services offers these suggestions for preventing antibiotic-resistant infections:
The U.S. Department of Health and Human Services offers these suggestions for preventing antibiotic-resistant infections:
- Talk to your doctor about whether you actually need an antibiotic to treat a particular illness.
- Don't take antibiotics when they are not helpful. For example, antibiotics will not treat infections caused by viruses, including the common cold and the flu.
- Always take antibiotics as prescribed by your doctor. Don't skip any dose, and don't stop taking them early, even if you feel better.
- Never "save" antibiotics to take later. Never re-use them for a different illness.
- Never take an antibiotic that was prescribed to another person.
Senin, 02 Maret 2009
Risk Score May Predict Abnormal Heart Rhythm
(HealthDay News) -- Weighing a combination of risk factors could help doctors predict which patients are the most likely to develop atrial fibrillation, a new study suggests.
To that end, the researchers have developed a risk score that might one day help prevent what has become the most common type of abnormal heart rhythm in the United States, affecting about 2.2 million people.
"We know a lot about the prevention of many different types of vascular disease, but there has been very little attention paid to preventing AF," said lead researcher Dr. Emelia Benjamin, a professor of medicine and epidemiology at Boston University School of Medicine.
But attention might be warranted, since the condition is on the increase in the United States. By 2050, almost 16 million Americans will have AF, Benjamin said. This dramatic increase is partly due to people living longer, so they are more likely to get diseases associated with aging. In addition, people with heart disease are living longer, she explained.
The condition causes the upper chambers of the heart to beat erratically, which hinders the heart's ability to pump blood. It can increase the risk of stroke, heart failure and dementia, and although it can be controlled with medication or surgical procedures, there is no way yet to keep it from developing, according to the American Heart Association.
The risk factors for AF are known, but they tend to be looked at one at a time, and there has been no way of predicting an individual's risk for the disease, Benjamin said. "We developed a risk score for new-onset AF that would work in a doctor's office, or a person could use it to figure out their risk of AF," she said.
The risk factors for AF include older age, being male, being overweight, hypertension, having a heart murmur and a history of heart failure, Benjamin said. "These have previously been described, but not put together in a risk score," she said.
The report is published in the Feb. 28 issue of The Lancet.
For the study, Benjamin's team, which included Dr. Renate Schnabel from the Johannes Gutenberg-University in Mainz, Germany, collected data on 4,764 people who participated in the Framingham Heart Study. These individuals were aged 45 to 95 and did not have AF. The selection of people for the study was made from examinations done between June 1968 and September 1987.
Over 10 years of follow-up, 10 percent of the people developed AF. The strongest factors that predicted the risk of developing AF were age, sex, weight, high blood pressure, being treated for high blood pressure, heart murmur and heart failure. In addition, the time between the P and R waves (PR interval), as seen on an electrocardiogram, was also a significant predictor of AF, the researchers found.
The risk of AF varied with age. Those over 65 were more than 15 times more likely to develop AF than people under 65, the researchers noted.
This risk score may help doctors and patients determine the risk for AF, Benjamin said. More important, this risk score might help doctors develop a way to prevent AF, she said.
"Before you can prevent something, you have to know how to predict it," Benjamin said. This risk score will be useful first to help patients understand their risk, second to provide information for clinical trials, and third to evaluate other ways of predicting AF, she said.
Dr. David Brieger, an associate professor from Concord Hospital at the University of Sydney in Australia and author of an accompanying journal comment, said this study could be a first step in finding a way to prevent AF.
"It may be possible to identify strategies, pharmacologic and others such as lifestyle, to prevent the onset of atrial fibrillation in high-risk patients," Brieger said.
Atrial fibrillation is a potentially disabling condition that is increasing in frequency and placing an increased burden on health care resources, Brieger noted. "Preventing this condition would have immense value. Identifying patients at high risk of developing the condition is an important initial step in this process," he added.
Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, said it is not clear how this risk score would change clinical practice.
"While helpful from a research standpoint, the potential clinical utility of this risk score requires validation in other populations and further study," Fonarow said. "It remains untested whether detection of increased risk of AF will result in any change in care or improve clinical outcomes."
More information
For more about atrial fibrillation, visit the American Heart Association.
To that end, the researchers have developed a risk score that might one day help prevent what has become the most common type of abnormal heart rhythm in the United States, affecting about 2.2 million people.
"We know a lot about the prevention of many different types of vascular disease, but there has been very little attention paid to preventing AF," said lead researcher Dr. Emelia Benjamin, a professor of medicine and epidemiology at Boston University School of Medicine.
But attention might be warranted, since the condition is on the increase in the United States. By 2050, almost 16 million Americans will have AF, Benjamin said. This dramatic increase is partly due to people living longer, so they are more likely to get diseases associated with aging. In addition, people with heart disease are living longer, she explained.
The condition causes the upper chambers of the heart to beat erratically, which hinders the heart's ability to pump blood. It can increase the risk of stroke, heart failure and dementia, and although it can be controlled with medication or surgical procedures, there is no way yet to keep it from developing, according to the American Heart Association.
The risk factors for AF are known, but they tend to be looked at one at a time, and there has been no way of predicting an individual's risk for the disease, Benjamin said. "We developed a risk score for new-onset AF that would work in a doctor's office, or a person could use it to figure out their risk of AF," she said.
The risk factors for AF include older age, being male, being overweight, hypertension, having a heart murmur and a history of heart failure, Benjamin said. "These have previously been described, but not put together in a risk score," she said.
The report is published in the Feb. 28 issue of The Lancet.
For the study, Benjamin's team, which included Dr. Renate Schnabel from the Johannes Gutenberg-University in Mainz, Germany, collected data on 4,764 people who participated in the Framingham Heart Study. These individuals were aged 45 to 95 and did not have AF. The selection of people for the study was made from examinations done between June 1968 and September 1987.
Over 10 years of follow-up, 10 percent of the people developed AF. The strongest factors that predicted the risk of developing AF were age, sex, weight, high blood pressure, being treated for high blood pressure, heart murmur and heart failure. In addition, the time between the P and R waves (PR interval), as seen on an electrocardiogram, was also a significant predictor of AF, the researchers found.
The risk of AF varied with age. Those over 65 were more than 15 times more likely to develop AF than people under 65, the researchers noted.
This risk score may help doctors and patients determine the risk for AF, Benjamin said. More important, this risk score might help doctors develop a way to prevent AF, she said.
"Before you can prevent something, you have to know how to predict it," Benjamin said. This risk score will be useful first to help patients understand their risk, second to provide information for clinical trials, and third to evaluate other ways of predicting AF, she said.
Dr. David Brieger, an associate professor from Concord Hospital at the University of Sydney in Australia and author of an accompanying journal comment, said this study could be a first step in finding a way to prevent AF.
"It may be possible to identify strategies, pharmacologic and others such as lifestyle, to prevent the onset of atrial fibrillation in high-risk patients," Brieger said.
Atrial fibrillation is a potentially disabling condition that is increasing in frequency and placing an increased burden on health care resources, Brieger noted. "Preventing this condition would have immense value. Identifying patients at high risk of developing the condition is an important initial step in this process," he added.
Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, said it is not clear how this risk score would change clinical practice.
"While helpful from a research standpoint, the potential clinical utility of this risk score requires validation in other populations and further study," Fonarow said. "It remains untested whether detection of increased risk of AF will result in any change in care or improve clinical outcomes."
More information
For more about atrial fibrillation, visit the American Heart Association.
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