That’s the takeaway from a recent report in Health Affairs. Researchers from Emory University looked at acute care visits, such as coughs, fevers and stomach aches, made between 2001 and 2004.

The team found that only 42% were made to patients’ personal physicians. Another 28% of visits took place at emergency departments. On the weekends and after office-hours, EDs saw virtually all of the visits. Patients without insurance made more than half of the visits to EDs.

Most of the remaining visits were made to specialists (20%) or outpatient departments (7%).

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Some interesting insights can be gleaned from a recent study by researchers at the Centers for Disease Control and Prevention.

The study found that total dollars spent on cancer care nearly doubled from $24.1 million in 1987 to $48.1 million in 2005. (Amounts in this article are all expressed in 2007 dollars.)  But cancer care as a share of total medical costs remained basically flat — rising from 4.8% in 1987 to 4.9% in 2005.

The researchers said the increase in costs was driven by more cancer cases — itself fueled by an increase in geriatric patients. Other changes in cancer care, such as a decrease in inpatient care and a dramatic increase in outpatient care, also contributed to shifts in where medical dollars are spent.

But while costs in general are up, the burden isn’t being shared equally among payers. The survey showed that in real dollars, some payers paid far more than others. Between 1987 and 2005 the costs incurred by:

• Medicaid increased 488%
• Private insurers increased 137%
• Medicare increased 99%
• Public programs (aside from Medicare/Medicaid) increased 25%, and
• Patients paying out-of-pocket costs decreased 7%.

Note: The researchers used data from the 1987 National Medical Expenditure Survey and the 2001-2005 Medical Expenditure Panel Survey.

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Pros: Better patient care overall. Cons: Docs working longer hours to make the same income.

That’s the result of recent research published in the Archives of Internal Medicine.

The research team collected retrospective data on more than 46,000 visits to primary care doctors by adult patients, between 1997 and 2005. The study showed that the number of visits increased 10% over that period and the average length of a visit increased 16%, from 18 minutes per patient to almost 21 minutes.

Some types of visits increased in duration more than others:

• regular check-ups increased by 3.4 minutes
• high blood pressure checks increased 3.7 minutes
• diabetes diagnoses increased 4.2 minutes, and
• joint disease diagnoses increased 5.9 minutes.

Part of the reason for longer visits is that patients are learning to be more involved in the health care decision-making process, so they come to appointments armed with questions about tests, medications they’ve seen advertised and that tip Aunt Hilda passed on about how eating raw garlic can ward off arthritis.

While few would argue against patients being more engaged in their own care, dealing with those questions does take up valuable clinical time — and like it or not, doctors don’t get paid for their bedside manner. The end result is longer hours for doctors, while total compensation stays the same — if they’re lucky.

What can help

Some practices are instituting smart strategies to free up doctors’ time while still giving patients the time and attention they need and want.

Those strategies include having other staff on hand (physician’s assistant, nurse practitioners, etc.) to handle routine care, as well as group visits, where patients with similar conditions can meet with clinicians to discuss outpatient care and self-management.

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Is there a legitimate use for Twitter as a health care delivery service? Yes, according to some professionals in the field — if the “just for fun” service is approached from the right perspective.

Far from being just a way to announce what you had for lunch, some providers and patients are using social networking tools to gather and send relevant health data. Registered nurse Phil Baumann recently wrote an article outlining 140 legit medical uses for Twitter and similar sites, including ways to spread information to patients or staff, as well as gather patient data.

Among them:

• Sharing authoritative health/wellness advice
• Arranging outpatient care and support
• Assisting patients to manage diabetes and other chronic health issues
• Nutritional, exercise and other daily health logs
• Sharing FDA safety alerts
• Recruiting for tissue donation, health studies, etc.
• Managing shift workers’ schedules, and
• Reporting adverse events and reactions.

Twitter can’t take the place of all forms of patient interaction, obviously. Not everyone will be interested in joining the latest trend. Not to mention that the open nature of social networking sites requires some serious consideration of HIPAA issues when dealing with patient data.

But embracing newer forms of communication can help provide better care for some patients.

Tell us how social networking tools could help your hospital or practice provide better care — and what concerns you may have about using them.

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