Page 28 - aruba-today-20200111

A28 SCIENCE
Saturday 11 January 2020
Program meant to curb repeat hospital stays fails big test

By MARILYNN MARCHIONE "If you're in a shelter or on
AP Chief Medical Writer the streets, it's just not easy
Researchers thought they to help and that sometimes
had a way to keep hard- leads to more hospitaliza-
to-treat patients from con- tions," said the Camden
stantly returning to the hos- project's leader, Kathleen
pital and racking up big Noonan.
medical bills. Health work- Three months of help also
ers visited homes, went wasn't enough, and there
along to doctor appoint- weren't enough places to
ments, made sure medi- get help for mental health
cines were available and or substance abuse prob-
tackled social problems in- lems, she added.
cluding homelessness, ad- "We've evolved a lot" since
diction and mental health the program began, said
issues. Brenner, who now is an ex-
Readmissions seemed to ecutive working on similar
drop. The program looked programs at the insurance
so promising that the fed- company UnitedHealth-
eral government and the care.
MacArthur Foundation "The system is good at de-
gave big bucks to expand livering care if you're an
it beyond Camden, New average patient on an
Jersey, where it started. average day," but not for,
But a more robust study say, a homeless person in
released Wednesday re- a wheelchair who is disori-
vealed it was a stunning In this undated photo provided by Camden Coalition, its staff members discuss patient engage- ented, Brenner said. "These
failure on its main goal: Re- ment. patients have complex
admission rates did decline, Associated Press problems. If you don't meet
but by the same amount as their needs, they'll keep go-
for a comparison group of with hospitals in Camden, nurses, social workers and that suddenly improved, it ing to the hospital."
similar patients not in the a city with high poverty others coordinating their could explain why the pro- The program was "clearly
costly program. and crime rates, to identify care for three months. Pa- gram failed to prove bet- done with the best of in-
"There's real concern that people who go to hospitals tients received seven to ter. tentions" and still may have
the response to this would frequently and target them eight home visits and nine However, two key goals provided useful care to
be to just throw up our with special services. He phone calls on average. of the program — a home the people who received
arms" and say nothing can won a MacArthur genius The effort cost about $5,000 visit and a trip to a health it even though it didn't re-
be done to help these so- grant for the work, and fed- per patient. provider within a week duce readmissions, said
called frequent fliers of the eral grants expanded the Six months later, the re- of leaving the hospital — Dr. Aaron Kesselheim, a
medical system, said study program to Aurora, Colo- admission rate was 62% were met for only 28% of Harvard Medical School
leader Amy Finkelstein. rado; Kansas City, Missouri; in both groups, and there participants. Homelessness health policy expert who
Instead, researchers need Allentown, Pennsylvania; was no difference in total and lack of a telephone had no role in the work.
to seek better solutions and and San Diego. The govern- health care spending. were big reasons, and the Problems like readmission
test them as rigorously as ment also paid for a study Researchers don't know program more recently has are much more complicat-
new drugs, said Finkelstein, to see if it truly worked. what usual care was for worked harder to get peo- ed than they appear to be,
of the Massachusetts Insti- The study enrolled 800 hos- the comparison group. If ple into stable housing. he said.q
tute of Technology and the pitalized Camden patients
National Bureau of Eco- with at least two other ad-
nomic Research. months and at least two Mexico goals: science, tourism
missions in the previous six
Federal grants and re-
search groups at MIT paid of these conditions: home-
for the study, which was lessness, drug use, a men- in Latin America, Caribbean
published in the New Eng- tal health problem, trouble
land Journal of Medicine. accessing services, lack of
Just 5% of the U.S. popula- social support or use of five Mexico proposed joint since we met," Ebrard said. operation on technology,
tion accounts for half of or more medicines. goals for science, space, "It was very difficult to even space, science and disas-
health care spending, and Half were given usual care tourism and sustainability meet, because of the po- ter prevention.
hospitalization is a big part. when they left the hospi- for the region's nations at litical polarization. Mexico is also proposing
A decade ago, Dr. Jeff tal. The rest were enrolled the meeting Wednesday "We are not going to dis- cooperation on ocean
Brenner started working in Brenner's program with of The Community of Latin cuss the same political is- management, drug-resis-
American and Caribbean sues that are discussed in tant infections, anti-poverty
States. Twenty-nine repre- all the (regional) forums, efforts and anti-corruption
sentatives of the 31-nation because there are other standards. In addition, the
body met in Mexico City. platforms for that, for that plan would promote joint
Marcelo Ebrard, Mexico's there is the Organization of contacts and agendas in
foreign minister, said he American States, the U.N." international forums.
wants to keep the body Ebrard proposed a 14-point Debate in other regional
on a track of cooperation, cooperation plan that in- forums have often focused
rather than the same old cludes joint purchasing on highly polarizing issues
political debates that have arrangements from multi- like the political and eco-
dominated other regional national corporations for nomic crisis in Venezuela,
meetings. articles like medications. or the ouster of Bolivian
"It has been some time The plan also includes co- President Evo Morales.q