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first_img <a href=”https://www.youtube.com/watch?v=7Ot-LpNEWJY” rel=”nofollow” target=”_blank”> <img src=”https://img.youtube.com/vi/7Ot-LpNEWJY/0.jpg” alt=”0″ title=”How To Choose The Correct Channel Type For Your Video Content ” /> </a> While all groups spent the same 20 minutes face-to-face with physicians, blacks and Hispanics spent approximately 25 percent longer when seeking health care than whites, a result of increased travel, wait, and administrative times. Courtesy of Harvard Medical School Writing in the American Journal of Managed Care, the researchers reported that the average total visit time for a person seeking care for themselves, a child, or another adult was 121 minutes. That total includes 37 minutes of travel time and 84 minutes in the clinic. Of those 84 minutes, people spent only 20 minutes with physicians; they spent the rest of the time waiting, interacting with nonphysician staff, or completing paperwork or billing.Economists calculate the value of time spent doing an activity — known as opportunity cost — based on the income that an individual would earn working the same amount of time. The researchers calculated that the average opportunity cost per visit was $43, compared with an average out-of-pocket cost per visit of $32.“We also found that this time burden fell disproportionately on the disadvantaged,” said Kristin Ray, assistant professor of pediatrics at the University of Pittsburgh School of Medicine.Writing in JAMA Internal Medicine, the researchers reported that, while all groups spent the same 20 minutes face-to-face with physicians, blacks and Hispanics spent approximately 25 percent longer when seeking health care than whites, a result of increased travel, wait, and administrative times. Lower-income groups and the unemployed also spent more time seeking care than their better-off counterparts.“Typically, when we talk about how much we spend on health care, we focus on what is paid to doctors and hospitals through co-pays and insurance payments,” said Mehrotra, who is also a physician and HMS professor of medicine at Beth Israel Deaconess Medical Center. “This work helps us put a dollar amount on the significant time it costs people to seek health care.”The researchers said that it is important to consider time costs when evaluating innovative treatment and care delivery models designed to create higher-value, more-patient-centered care and to reduce health care disparities. They noted that many initiatives currently underway might offer considerable benefits in reducing the time-cost burden of health care. These initiatives include streamlining office visits; incorporating clinics into schools, community centers, and places of work; and using new models of care delivery, such as telemedicine visits, e-visits, and other Internet-powered medicine.The researchers combined data from several sources to calculate time spent in transit, at the clinic, and with clinicians face-to-face. One key resource was the American Time Use Survey, which ties detailed reporting about how respondents spend their day in a given 24-hour period with demographic and income information. In 2010, people in the United States spent 1.1 billion hours seeking health care for themselves or for loved ones. That time was worth $52 billion.“That’s about the same as all of the time worked in a year by the entire working population of the city of Dallas,” said Ateev Mehrotra, associate professor of health care policy and medicine at Harvard Medical School (HMS). Mehrotra is a lead author of two studies published this fall that measure the amount of time patients spend seeking care; calculate the total time costs to society; and analyze the difference in time burden by race, ethnicity, and socioeconomic status.The hidden cost of health carelast_img read more

first_imgAll clubs are to be warned to follow the rules governing players suffering concussion following the controversy surrounding Tottenham goalkeeper Hugo Lloris. Spurs have defended their handling of the incident where manager Andre Villas-Boas allowed the Frenchman to remain on the pitch against Everton on Sunday despite having been knocked out in a collision with Romelu Lukaku’s knee and initially being unable to remember where he was. FIFA’s chief medical officer and the Professional Footballers’ Association say, under current regulations, that Lloris should have been substituted. Tottenham’s head of medical services Wayne Diesel said: “Once the relevant tests and assessments were carried out, we were totally satisfied that he was fit to continue playing.” FIFA’s chief medical officer, professor Jiri Dvorak, said if there is any doubt about concussion then the player should be removed from the field of play. Dvorak said there was a “99 per cent probability” that Lloris would have been concussed – and pointed out that Everton striker Lukaku needed an ice-pack on his knee afterwards. “The player should have been substituted,” Dvorak told Press Association Sport. “The fact the other player needed ice on his knee means it’s obvious the blow was extensive. “It’s a 99 per cent probability that losing consciousness in such an event will result in concussion.” Dvorak added that the player’s view should not be taken into account in such situations. He said: “When he has been knocked unconscious, the player himself may not see the reality. “I do not know the details but I know that the Premier League doctors are extremely good and I can imagine that the doctor may have recommended he be replaced. “We have a slogan: if there is any doubt, keep the player out.” Villas-Boas’ decision has been criticised as “dangerous” and “irresponsible” by brain injury charity Headway. Luke Griggs, spokesperson for Headway, said: “We are hugely concerned that a professional football club should take such an irresponsible and cavalier attitude to a player’s health.” The FA has detailed regulations on head injuries and concussion and, although it is understood the governing body is not investigating Tottenham’s handling of the incident, the rules state that anyone suffering unconsciousness should not play again that day. The rules do, however, allow for “a transient alteration of conscious level” following a head injury, which says a player can return to play following assessment by medical staff. Coincidentally, Lukaku was himself the centre of a concussion scare at West Ham earlier in the season when he suffered a blow to the head while scoring, but played on and afterwards said he could not remember anything about his goal. The international players’ union FIFPro also criticised Tottenham for allowing Lloris to continue. The incident was raised by PFA chief executive Gordon Taylor at a quarterly meeting with representatives from the Football Association, Premier League and Football League on Monday, where it was decided to remind clubs of the protocol for concussion. Taylor told Press Association Sport: “I watched the incident on television and I was surprised to say the least that he was allowed to stay on. “We are very concerned that the protocol that involves concussed players was not adhered to and I raised this at the meeting with the professional game’s stakeholders today, and the decision was taken to remind all clubs of the protocol. “Managers should not take these decisions in the heat of the moment and that needs reinforcing.” Taylor said the PFA wants the rules made even tougher so that any player who loses consciousness during a match should be automatically removed from the field of play rather than leaving it up to medical staff to make a decision. Lloris was unable to remember the incident and was taken for a brain scan but given the all-clear. Questions remain, though, over Villas-Boas’ decision. Immediately after the match he told Sky Sports: “The medical department was giving me signs that the player couldn’t carry on, because he couldn’t remember where he was.” In a statement, however, Tottenham said medical staff were “totally satisfied that he was fit to continue playing”. The club did not respond to further questions asking whether Lloris did in fact suffer concussion – under current rules that will require at least a week’s rest and further tests. Press Associationlast_img read more