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Health Biz: Old Care Choice Habits Persist



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WASHINGTON, Apr 20, 2004 (United Press International via COMTEX) -- Forget performance data, science-based medicine and all the other quality care information aimed at creating better educated healthcare consumers. It seems people still decide about the best doctors and hospitals the old-fashioned way -- through media reports and by talking to friends, family and co-workers.

A survey of 1,500 New Yorkers by the non-profit New York Academy of Medicine finds few people use so-called official health data -- such as physician misconduct records or reports comparing hospital surgical success rates -- in making healthcare decisions, even though that information is available and often offered by government agencies, health plans and other providers.

The survey is published in the current issue of the Journal of Public Health Management

Joseph A. Boscarino, senior scientist at the academy's Division of Health and Science Policy, told UPI's HealthBiz the results were somewhat of a surprise, but they underscored the need for a better understanding of the consumer.

"We kind of expected some of it but we didn't realize how much significance folks put on referrals from co-workers, friends and family members," he said. "We need to take that into consideration."

As for healthcare information people glean from the Internet, the survey found "they don't trust it hardly at all," Boscarino said.

The survey also found less than half of respondents recalled hearing or seeing quality data in the past year, while 17 percent turned to the media for information on doctors and 20 percent sought out friends, family, co-workers or health professionals. The percentages were similar for hospitals.

"Half the public doesn't recall anything," Boscarino said. "Unless they have a healthcare crisis they aren't even looking for it."

When quality information did factor into decision-making, whether a physician was board certified and the number of malpractice suits against a doctor were more important to people than ratings by government agencies or information distributed by health plans.

Boscarino said more study is needed, because if the goal is to change public health practices "you really have to understand how the individual perceives and uses the information."

CONTROVERSY OVER AIDS POLICY

Physicians and other health providers treating patients with HIV/AIDS are upset over a proposed Bush administration policy on using the President's Emergency Plan for AIDS Relief funds to purchase anti-retroviral drugs for patients in developing countries.

The HIV Medicine Association and the Infectious Diseases Society of America have written the administration, urging officials to adopt World Health Organization quality standards instead of requiring generic AIDS drugs already being used in these areas to undergo a separate U.S. approval process before being eligible for purchase under the PEPFAR program.

PEPFAR grant recipients currently are prohibited from using those monies to buy generic combination anti-retrovirals, even those already certified through the WHO Prequalification Program for Certifying Drugs for Purchase by U.N. Agencies, which is run by an international panel of experts and includes manufacturing site inspections.

Christine Lubinski, executive director for HIVMA, which has more than 2,600 members -- including physicians, scientists and other healthcare professionals -- said she has discussed the matter with administration officials, who told her it is not cheaper to use generic drugs because their manufacturers will not help distribute the medications.

"I have run that by people in the field who say that is absurd," Lubinski told HealthBiz. "It doesn't make any sense to us."

Lubinski said it raises questions about how much influence the big pharmaceuticals companies have over U.S. policy, because the WHO certification process is very extensive and removes threats that generic drugs might be counterfeit, or may not equivalent to brand name drugs.

The administration has said it will issue a revised policy proposal next week and will accept comments from the public and industry.

PROTESTING PAIN

Concern by physicians and patients over "friendly fire" from evolving U.S. policy in the "War on Drugs" spilled into Washington this week during protests at the Capitol. Some doctors claimed they have had difficulty prescribing painkillers for legitimate use by patients because of the U.S. law enforcement crackdown on the recreational use of medications, such as OxyContin.

The Association of American Physicians and Surgeons helped to publicize the events, which included a National Pain Patients Coalition Leadership Summit and a National Pain Rally at the Capitol.

Hundreds of pain patients, families and doctors presented a pain quilt and petitions to members of Congress calling for congressional hearings on Drug Enforcement Agency actions in which physicians are threatened, delicensed and imprisoned for prescribing drugs to patients with severe or chronic pain.

Information on the AAPS Web site documents physicians who have been prosecuted, including one physician in Myrtle Beach, S.C., who was sentenced to eight years in prison for being part of an alleged OxyContin conspiracy. AAPS said the sentence was based on her working for 57 days at a pain clinic in Myrtle Beach.

STATE PROGRAMS CAN HELP DRUG CARD ENROLLEES

The Centers for Medicare and Medicaid Services says state pharmacy assistance programs can automatically enroll low-income Medicare beneficiaries into discount drug card programs. States with authority to act as an "authorized representative" of a beneficiary -- and this is defined by state law -- will be allowed to act on behalf of low-income beneficiaries to get them the extra $600 in help on top of the discounts.

CMS says Medicare also will issue a standard enrollment form that will be accepted by all approved discount card programs, making it easier for community groups to help seniors enroll in the program.

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E-mail ebeck@upi.com

Copyright 2004 by United Press International.

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