Linnea A. Polgreen

Employment Among Survivors of Lung Cancer and Colorectal Cancer

PURPOSE To identify the frequency of and factors associated with changes in employment among cancer survivors. METHODS This prospective cohort study took place in the context of the population-based Cancer Care Outcomes Research and Surveillance Consortium. Patients with nonmetastatic lung or colorectal cancer who survived approximately 15 months after diagnosis without cancer recurrence provided their self-reported employment status, employment experiences, and changes in insurance coverage at 4 and 15 months after diagnosis. Multiple logistic regression was used to relate sociodemographic and disease factors to the probability of labor force departure. RESULTS Among 2,422 eligible patients, employment declined from 3% to 31% over the 15 months after cancer was diagnosed. Labor force departures attributable to cancer occurred in 17% of those employed at baseline. Factors associated with significantly higher rates of labor force departure were lung versus colon cancer, stage III versus I or II disease, lower educational and income levels, and, among colorectal patients, older age. Married women were significantly more likely than unmarried women to leave the workforce. Only 2% of patients lacked health insurance during the study period. CONCLUSION Most employed patients with nonmetastatic lung or colorectal cancer return to work, but approximately one sixth of patients leave the workforce, particularly those with worse prognoses or lower socioeconomic status. Potential economic effects must be considered in management decisions about cancer.

COST EFFECTIVENESS OF A PHYSICIAN-PHARMACIST COLLABORATION INTERVENTION TO IMPROVE BLOOD PRESSURE CONTROL

Previous studies have demonstrated the cost-effectiveness of physician–pharmacist collaborations to improve hypertension control. However, most studies have limited generalizability, lacking minority and low-income populations. The Collaboration Among Pharmacist and Physicians to Improve Blood Pressure Now (CAPTION) trial randomized 625 patients from 32 medical offices in 15 states. Each office had an existing clinical pharmacist on staff. Pharmacists in intervention offices communicated with patients and made recommendations to physicians about changes in therapy. Demographic information, blood pressure (BP), medications, and physician visits were recorded. In addition, pharmacists tracked time spent with each patient. Costs were assigned to medications and pharmacist and physician time. Cost-effectiveness ratios were calculated based on changes in BP measurements and hypertension control rates. Thirty-eight percent of patients were black, 14% were Hispanic, and 49% had annual income <

A statewide system for improving influenza vaccination rates in hospital employees.

25 000. At 9 months, average systolic BP was 6.1 mm Hg lower (±3.5), diastolic was 2.9 mm Hg lower (±1.9), and the percentage of patients with controlled hypertension was 43% in the intervention group and 34% in the control group. Total costs for the intervention group were

Increasing Trend in Admissions for Malignant Hypertension and Hypertensive Encephalopathy in the United States

1462.87 (±132.51) and

Hospital Transfer Network Structure as a Risk Factor for Clostridium difficile Infection

1259.94 (±183.30) for the control group, a difference of

Voluntary reporting of employee influenza vaccination rates by acute care hospitals in Iowa: The impact of a four year provider-based statewide performance improvement project

202.93. The cost to lower BP by 1 mm Hg was

Outpatient blood pressure monitoring using bi–directional text messaging

33.27 for systolic BP and

Web search query volume as a measure of pharmaceutical utilization and changes in prescribing patterns

69.98 for diastolic BP. The cost to increase the rate of hypertension control by 1 percentage point in the study population was

Recent Trends in the Skill Composition of Legal U.S. Immigrants

22.55. Our results highlight the cost-effectiveness of a clinical pharmacy intervention for hypertension control in primary care settings.

Increased Statin Prescribing Does Not Lower Pneumonia Risk

OBJECTIVE To describe and report the progress of a provider-initiated approach to increase influenza immunization rates for healthcare workers. DESIGN Observational study. SETTING The State of Iowa. SUBJECTS Acute care hospitals in Iowa. METHODS Hospitals reported rates of employee influenza vaccination to a provider-based collaborative during 2 influenza seasons (2006-2007 and 2007-2008). Hospital characteristics related to higher vaccination rates were examined. RESULTS One hundred (87.0%) of 115 Iowa hospitals and/or health systems participated in season 1; individual hospital vaccination rates ranged from 43.5% to 99.2% (mean, 72.4%; median, 73.1%). In season 2, 115 (100%) of 115 Iowa hospitals and/or health systems participated. Individual hospital vaccination rates ranged from 53.6% to 100% (mean, 79.5%; median, 82.0%). In both seasons, urban and large hospitals had vaccination rates that were 6.3% to 7.6% lower than those of hospitals in other locations. Hospitals that used declination statements had influenza vaccination rates 12.6% higher than hospitals that did not use declination statements in season 2. CONCLUSION The initial vaccination rates were high for healthcare workers in Iowa, especially in smaller rural hospitals, and rates increased during season 2. The successful voluntary approach for reporting influenza vaccination rates that we describe provides an efficient platform for collecting and disseminating other statewide measures of healthcare quality.