Data hint at disparities in COVID-19 outcomes | Home hospital care tied to lower health care costs, readmission | Hospitalization for influenza linked to readmission risk
April 9, 2020
CV Quality SmartBrief
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First Focus
Preliminary state-level data show blacks have higher odds of dying from COVID-19 than people from other racial groups, and the disparity is evident in Illinois and Michigan where blacks account for 40% of deaths but just 14.6% and 14% of their state's populations, respectively. Summer Johnson McGee, dean of the School of Health Sciences at the University of New Haven, said blacks could be particularly vulnerable because they have higher rates of pre-existing illnesses, linked to environmental and economic factors.
Full Story: CNN (4/7),  Reuters (4/6) 
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A randomized controlled trial published in the Annals of Internal Medicine showed home hospital care was associated with a lower 30-day hospital readmission rate, lower health care costs and fewer consultations for acutely ill patients compared with traditional hospital care. Patients who received home care also had less sedentary time compared to those who received hospital care.
Full Story: RevCycle Intelligence (4/6) 
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A study in the Journal of Infectious Diseases linked being hospitalized for influenza to a higher risk of readmission within 30 days and one year. Common reasons for readmission included cardiovascular, respiratory and infectious disease problems.
Full Story: Infectious Disease Advisor (4/6) 
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Practice & Hospital Management
The CMS has paid almost $34 billion in advance and accelerated Medicare payments to providers and this week plans to send hospitals the first $30 billion from $100 billion allocated in the Coronavirus Aid, Relief, and Economic Security Act. The American Clinical Laboratory Association has asked HHS to allow commercial labs to receive funding from the CARES Act's Public Health and Social Services Emergency Fund.
Full Story: FierceHealthcare (4/7),  Healthcare Dive (4/6),  Healthcare Dive (4/8) 
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The CDC issued new guidelines allowing essential workers such as those in the health care and the food supply industry who have been exposed to people with confirmed or suspected COVID-19 to return to work if they're not showing any symptoms. The agency advises affected people to practice social distancing, wear face masks and take their temperatures before starting work.
Full Story: NBC News/The Associated Press (4/8) 
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Autoclaving, ionized hydrogen peroxide fogging, ethylene oxide gassing and vaporized hydrogen peroxide treatment yielded high efficacy in sterilizing contaminated N95 masks, and the autoclave treatment allowed the reuse of masks for at least 10 cycles, researchers in Canada reported in a prereview analysis. The findings also showed no filter function loss after several cleanings with two of the sterilization techniques.
Full Story: Health Imaging online (4/6) 
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Innovation & Technology Trends
Health systems have found that flexibility, having a mission control center, using technology tools and making a quick transition to telehealth have helped the response to the novel coronavirus pandemic. "We have to be nimble, flexible, adaptable in this incredibly changing environment," Dr. Amy Compton-Phillips, executive vice president and chief clinical officer at Providence St. Joseph Health, said in a webinar hosted by Modern Healthcare.
Full Story: SmartBrief/Health Care (4/8) 
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Prevention & Research News
Exposure to air pollution may reduce the cardiovascular benefits linked to intensive blood pressure lowering, according to a study presented at the ACC.20 Together With World Congress of Cardiology Virtual. Researcher Sadeer Al-Kindi said fine particulate matter is considered the "most important environmental risk factor, contributing to global cardiovascular mortality, and possibly one of the mechanisms that mediate the effects on cardiovascular disease is through blood pressure."
Full Story: Healio (free registration)/Cardiology Today (4/8) 
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Some people with COVID-19 are suffering heart damage instead of or in addition to lung damage, and though the heart can be damaged by systemic inflammation, JAMA Cardiology Editor Robert Bonow says the virus could be directly infecting the heart muscle. A study in China showed heart damage in 19% of COVID-19 patients, and the mortality rate was 51% in that subset, compared with 4.5% in those with no signs of heart damage.
Full Story: Kaiser Health News (4/6) 
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Other News Highlights
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ACC News
As part of ongoing efforts to collect meaningful data and improve patient care, the ACC is launching an open comment period on the addition of shared decision-making documentation to the ICD Registry. In addition, modifications have been made to include indications for select pacing procedures; CRT-P devices, His Bundle pacing and leadless pacing. New lead locations have also been added. In the ICD Registry Version 2.3, data collection options will be available for either one or both ICD and pacemaker procedure types. Please review the data collection form before completing the survey. The survey should take 5 to 10 minutes to complete, including time to review the data collection form, and will close Monday, May 4. Take the survey now.
The ACC continues to stress the need for more personal protective equipment and COVID-19 tests, along with continued support for telehealth, clarity on liability, and more and better data from which to model the effect and duration of the pandemic. Learn more about all the ways the ACC, along with the broader medical community, is urging lawmakers, the Centers for Medicare and Medicare Services, and other policymakers to protect patients and clinicians. In addition, check ACC's COVID-19 Hub for the latest clinical guidance, perspectives from the front lines, coding and reimbursement updates, and more.
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Bewildered, bewildered, you have no complaint. You are what you are, and you ain't what you ain't.
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This news roundup is provided as a timely update to ACC members and partners interested in quality health care topics in the news media. Links to articles are provided for the convenience of the health care professionals who may find them of use in discussions with patients or colleagues. Opinions expressed in CV Quality SmartBrief are those of the identified authors and do not necessarily reflect the opinions or policies of the American College of Cardiology. On occasion, media articles may include or imply incorrect information about the ACC and its policies, positions, or relationships. For clarification on ACC positions and policies, we refer you to
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