News Briefs: March 14, 2010

Cost-Effectiveness of Mandatory EKG Screening for Athletes

Priya Larson

Seemingly healthy athletes with undetected heart conditions are at risk for cardiac failure while performing rigorous activity. According to recent studies, electrocardiogram screening can prevent sudden cardiac death of athletes in a cost-effective manner. In Italy, competitive athletes have been required to undergo EKG screening, and a 2006 JAMA study found that the number of cardiac deaths in athletes ages 14-35 decreased by 89 percent with screening. Essentially, EKG screening makes the rate of cardiac death equal between athlete and non-athlete groups.

Currently, the American Heart Association does not give any recommendation for EKG screening, and one argument against such a recommendation is the high expense associated with the number of preventable deaths. However, a 2010 study published in The Annals of Internal Medicine electronically simulated the cost per number of cardiac deaths prevented. The results? Screening all athletes is cheaper per athlete in terms of deaths prevented, and it saves more life-years per 1,000 athletes than the regular physical examination.

Reference: Bakalar, Nicholas. (2010, March 1). Screening May Save Athletes. The New York Times. Retrieved March 14, 2010 from http://www.nytimes.com/2010/03/02/health/02heart.html?ref=health.

Image: EKG of a 26-year-old man. Available here.


New Law Concerning Mental Health Benefits
Virginia Saurman

“Parity law requires mental health benefits comparable to physical care benefits” The Washington Post 3-2-10

As reported by the Washington Post, on January 1, 2010 a new federal law guaranteeing equality in insurance coverage came into effect, prohibiting restrictions such as higher deductibles and steeper co-pays for mental health and substance abuse treatment. For approximately 140 million Americans insured by their employers, the cost of mental health and/or substance abuse payments is now in line with physical care benefits. However the law does not mandate employers to provide coverage for mental health and substance abuse; nor does it apply to individual coverage policies. Concerning this new federal law, the Obama administration put forth 154 pages of regulations governing its implementation. The rules must go through a comment period before officially going into effect on July 1.
Federal estimates suggest that the law will increase premiums nationwide by 0.04 %, or about $25.6 billion, over ten years. Studies have shown that parity expands coverage without drastically increasing employers and insurers expenses. Employers can apply the same standards to mental health and substance abuse coverage as they do for physical ailments. However, the requirements for mental health and substance abuse coverage can no longer be more stringent than those of physical coverage. Plans can also reject coverage for conditions like eating disorders, so long as state laws do not mandate coverage. If insurers’ costs rose by more than 2 % in the first year, they can file for an exemption to the law. Advocates of the law are concerned that employers and insurers will use loopholes in the law to keep costs down, thus not at parity for the insured. However, they also rejected the idea that the regulations were onerous. “[Employers and insurers] still have enormous tools and leverage to control inappropriate [or excessive] treatment,” said Andrew Sperling, the director of federal legislative advocacy for the National Alliance on Mental Illness.

Reference: Boodman, Sandra G. (2010, March 2). Parity Law Requires Mental Health Benefits Comparable to Physical Care Benefits. The Washington Post. Retrieved March 14, 2010 from http://www.washingtonpost.com/wp-dyn/content/article/2010/03/01/AR2010030102903.html.

Caring for Terminally Ill Children
Alex Sakers

End of life care for a terminally ill and suffering child can be an extremely trying and difficult process. In a recent study, involving a sample of parents whose children had died of cancer, 1 out of 8 parents surveyed expressed that they had considered hastening the death of their child. The amount of pain and suffering that the child was experienced affected the likelihood of such thoughts; parents whose children were suffering more were more likely to have these thoughts. The study asked parents about both the death of their child and about hypothetical situations involving a child with a terminal illness or in a terminal coma. Parents were 40% more likely to approve of an earlier death if the child of the hypothetical situation was in pain rather than in a coma. The researchers stated in an interview “the important point is that these considerations may be mitigated if we did a better job taking care of children suffering while we are doing end of life care”. The suggestion that parents may be less likely to consider an early death for their child if their suffering is lessened, suggests that advances in palliative care for terminally ill children would not only lessen the suffering of the child, but also that of the parents.

Reference: Cooney, Elizabeth. (2010, March 1). Parents Weigh Hastening Death of Children with Terminal Cancer, Boston Study Finds. The Boston Globe. Retrieved March 14, 2010 from http://www.boston.com/news/health/blog/2010/03/parents_weigh_h.html.

Modifying Guidelines for Children Receiving CT Scans
Kristin Bradley

CT scans are especially dangerous for children, but over 3.5 million children receive these tests every year, especially to check for traumatic head injuries. Emergency care doctors at the University of California Davis are aiming to modify the guidelines currently used for assessing head injuries so that only children at higher risk for developing traumatic brain injuries (TBI) than for developing cancer from exposure to radiation from the CT scan will undergo the procedure. According to a recently published study from doctors at UC Davis in conjunction with the Pediatric Emergency Care Applied Research Network, doctors can maintain 99.9% accuracy in assessing risk for TBI before ordering a scan by monitoring warning signs such as mental awareness as well as skull fractures or swelling before ordering any tests. It remains to be seen how well the new diagnostic procedure will be accepted by the doctors who will ultimately decide whether or not to order the scans.

Reference: Landro, Laura. (2010, March 1). Cutting the Risk from CT Scans. The Wall Street Journal. Retrieved March 14, 2010 from http://blogs.wsj.com/health/2010/03/01/cutting-the-risk-from-ct-scans/.

Eriene-Heidi Sidhom is the 2009-2010 News and Analysis Editor.