In the News

Foodborne Illness Costs Nation $152 Billion Annually

Studies Examine Team Approaches to Hospital Care

Prevalence of Childhood Chronic Health Conditions Has Increased

National Human Genome Research Institute Launches Online Genomics Center for Educators of Nurses, Physician Assistants

Foodborne Illness Costs Nation $152 Billion Annually

Acute foodborne illnesses cost the United States an estimated $152 billion per year in health care and workplace and other economic losses, according to a report recently published by the Produce Safety Project (PSP).

The study, “Health-Related Costs from Foodborne Illness in the United States,” was written by Robert L. Scharff, PhD, JD, a former US Food and Drug Administration (FDA) economist and current Ohio State University assistant professor in the Department of Consumer Sciences. The study estimates that more than a quarter of these costs, an estimated $39 billion, are attributable to foodborne illnesses associated with fresh, canned, and processed produce.

The FDA has announced that before the end of the year it will propose mandatory and enforceable safety standards for the growing, harvesting, and packing of fresh produce. These will be the first nationwide safety standards for fresh fruits and vegetables.

Produce (fresh, canned, and processed) accounts for roughly 19 700 000 of the reported illnesses documented, at a cost of approximately $1960 per case and $39 billion annually in economic losses. California, Texas, New York, Florida, Illinois, and Pennsylvania were the states most affected by foodborne illness cases related to produce.

According to the author, “The contribution of this study is that it provides more complete estimates of the health-related cost of foodborne illness in the United States by summing both medical costs (hospital services, physician services, and drugs) and quality-of-life losses (deaths, pain, suffering, and functional disability) for each of the major pathogens associated with foodborne illness.” 

Dr Scharff based his analysis on the economic principles currently used by FDA and US Department of Agriculture economists in their cost analyses. In addition, to account for uncertainty, he used confidence intervals and sensitivity analysis.

In additional to national data, the report includes data at the state level, and the cost of foodborne illness is calculated on both an aggregate level and a pathogen-specific level.

To view a full copy of the report and the state-by-state data analysis, visit www.producesafetyproject.org and click on the Health-Related Costs report.

Studies Examine Team Approaches to Hospital Care

Multidisciplinary care teams consisting of clinicians, nurses, and other health care professionals appear to be associated with a lower risk of death among patients in the intensive care unit, according to a report in a recent issue of Archives of Internal Medicine. A second report finds that an increasing number of surgical patients are being managed jointly by a surgeon and another clinician, such as a hospitalist or internal medicine subspecialist.

More than 4 million patients are admitted to the intensive care unit (ICU) each year. These patients are often at a high risk of death from conditions such as sepsis and acute lung injury. Studies have shown that the presence of trained intensivist physicians is associated with improved survival, but there are not enough of these clinicians to meet demand.

The researchers analyzed data from 107 324 patients admitted to 112 acute care hospitals between 2004 and 2006. Daily rounds conducted by a multidisciplinary care team were independently associated with a lower risk of death among ICU patients. Of the hospitals, 22 (19.6%) had an intensivist either consulting on or managing all cases and also had daily rounds conducted by a multidisciplinary care team. Patients at these hospitals were least likely to die, followed by patients at facilities without intensivist care but with multidisciplinary care teams.

In another report, Gulshan Sharma, MD, MPH, and colleagues at the University of Texas Medical Branch, Galveston, conducted a study of 694 806 Medicare fee-for-service beneficiaries hospitalized for one of 15 inpatient surgical procedures between 1996 and 2006. The researchers calculated the proportion of these beneficiaries who were co-managed during their hospital stay.

Between 1996 and 2006, 35.2% of the patients hospitalized for a common surgical procedure were co-managed by nonsurgical clinicians (23.7% by a generalist physician, 14% by an internal medicine subspecialist, and 2.5% by both). The percentage of patients who were co-managed remained steady from 1996 to 2000 and then increased sharply, by 11.4% per year between 2001 and 2006.

Older patients, those with more comorbid illnesses and those receiving care at midsized (200- to 499-bed), nonteaching or for-profit hospitals were more likely to be co-managed.

Prevalence of Childhood Chronic Health Conditions Has Increased

The rate of chronic health conditions among children in the United States increased from 12.8% in 1994 to 26.6% in 2006 for conditions such as obesity, asthma, and behavior/learning problems, according to a study in a recent issue of JAMA.

Understanding prevalence and dynamics of chronic conditions on a national scale is important when designing health policy, making accurate clinical predictions, and targeting interventions to prevent chronic conditions. Patterns of how childhood chronic conditions have changed over time have not been widely examined.

Jeanne Van Cleave, MD, of MassGeneral Hospital for Children, Boston, and colleagues estimated changes in prevalence, incidence, and rates of remission of broad categories of conditions using three consecutive cohorts of children and examined the prevalence of having a condition during any part of the 6-year study period. The researchers used data from the National Longitudinal Survey of Youth-Child Cohort (1988-2006), which consisted of three nationally representative cohorts of children. Children were aged 2 through 8 years at the beginning of each study period, and the groups were followed up for 6 years, from 1988 to 1994 (cohort 1, n=2337), 1994 to 2000 (cohort 2, n=1759), and 2000 to 2006 (n=905).

Items on the survey included reports by a parent of a child having a health condition that limited activities or schooling or required medicine, special equipment, or specialized health services and that lasted at least 12 months. Obesity was defined as a body mass index at or above the 95th percentile for age. Chronic conditions were grouped into four categories: obesity, asthma, other physical conditions, and behavior/learning problems.

The researchers found that prevalence of any chronic condition, including obesity, increased with subsequent groups. The prevalence at the beginning of the study for group 2 (16.6%) and group 3 (25.2%) was higher compared with group 1 (11.2%). The end-study prevalence of any chronic health condition was 12.8% for group 1 in 1994, 25.1% for group 2 in 2000, and 26.6% for group 3 in 2006.

Having a chronic condition was dynamic over time. Combining all groups, 16.6% of children had any chronic condition at the beginning of the study, and 20.8% reported a chronic condition at the end of the study period. Only 7.4% of all children reported a chronic condition both at baseline and at the end of the study, however; 13.4% of participants represented new cases. In 9.3% of children, a chronic condition was reported at baseline but resolved by the end of the study.

Additionally, the prevalence of having a chronic condition during any part of the 6-year study period was highest for group 3 (51.5%), and there were higher rates among male, Hispanic, and black youth.

National Human Genome Research Institute Launches Online Genomics Center for Educators of Nurses, Physician Assistants

An online tool to help educators teach the next generation of nurses and physician assistants about genetics and genomics has been launched by the National Human Genome Research Institute (NHGRI), part of the National Institutes of Health. The tool is part of NHGRI’s effort to address the growing need among health care professionals for knowledge in this area, which is paving the way for more individualized approaches to detect, treat, and prevent many diseases.

The Genetics/Genomics Competency Center (G2C2), developed by the University of Virginia in Charlottesville through a contract with NHGRI, is a free, Web-based collection of materials on genetics and genomics designed for educators who train nurses and physician assistants. To access this resource, visit www.g-2-c-2.org.

Nursing and physician assistant educators can use the Genetics/Genomics Competency Center to find and download materials for use in their classrooms. They also can share their favorite genomic and genetic teaching resources and materials with other educators by uploading material, which is regularly reviewed by the center’s editorial board to ensure quality.

The Genetics/Genomics Competency Center was created under the guidance of an advisory group made up of representatives from a wide range of research and professional organizations. In addition to the American Association of Critical-Care Nurses, participating organizations included the American Academy of Physician Assistants, the National Cancer Institute, the National Coalition for Health Professional Education in Genetics, the National League for Nursing, the National Society of Genetic Counselors, the Physician Assistant Education Association, and Sigma Theta Tau International, the honor society of nursing.

To encourage sharing and reduce duplication across health care disciplines, the Genetics/Genomics Competency Center helps to match existing educational resources with educational competencies for health professionals. The online center accomplishes this through sophisticated cross-mapping of learning activities and assessments, outcome indicators, and professional competencies.

For more information about NHGRI, visit www.genome.gov.