Podcast

GI Pearls – November-December 2017 – Episode 13

Show Notes for November-December 2017 – Episode 13
  1. Long-term proton pump inhibitors and risk of gastric cancer development after treatment for Helicobacter pylori: a population-based study – GUT
  2. Association Between Use of Thiopurines or Tumor Necrosis Factor Antagonists Alone or in Combination and Risk of Lymphoma in Patients With IBD – JAMA
  3. Complications of Bariatric Surgery: What You Can Expect to See in Your GI Practice – Am Journal Gastro
  4. Oversuse of Repeat Upper Endoscopy in the Veterans Health Administration: A Retrospective Analysis – Am Journal Gastro
  5. Estrogen replacement reduces risk and increases survival time in of women with HCC – CGH
  6. Hepatitis C virus testing for case identification in persons born during 1945–1965: Results from three randomized controlled trials. –  Hepatology
  7. Population based paternity rate and partner birth outcomes among Utah men with IBD – Am J Gastro
  8. Agreement between home-based Measurement of stool calprotectin and ELISA Results for Monitoring Inflammatory Bowel Disease Activity – CGH
  9. Prevalence of Eosinophilic Gastroenteritis and Colitis in a Population-based Study – CGH
  10. Tongxie Formula Reduces Symptoms of Irritable Bowel Syndrome – CGH
  11. Chromoendoscopy for Surveillance in Ulcerative Colitis and Crohn’s Disease: A Systematic Review of Randomized Trials – CGH
  12. Long-Term Efficacy and Safety of Cyclosporine in a Cohort of Steroid-Refractory Acute Severe Ulcerative Colitis Patients from the ENEIDA Registry (1989–2013): A Nationwide Multicenter Study – Am J Gastro
2017 · CGH · Podcast · Study

GI Pearls Episode 5 – Last two weeks of June 2017

Show Notes for 2017 Second two weeks of June 005
  1. Cost Utility Analysis of Topical Steroids Compared With Dietary Elimination for Treatment of Eosinophilic Esophagitis – CGH
  2. Incidence and Prevalence of Crohn’s Disease and Ulcerative Colitis in Olmsted County, Minnesota From 1970 Through 2010 – CGH
  3. Fecal Immunochemical Test Detects Sessile Serrated Adenomas and Polyps With a Low Level of Sensitivity – CGH
  4. Comparison of Two Intensive Bowel Cleansing Regimens in Patients With Previous Poor Bowel Preparation: A Randomized Controlled Study. – GIE
  5. Acute Fatty Liver Disease of Pregnancy: Updates in Pathogenesis, Diagnosis, and Management – ACG
  6. Disentangling the Association between Statins, Cholesterol, and Colorectal Cancer: A Nested Case-Control Study – PLOS Medicine
  7. Association of Gastric Acid Suppression With Recurrent Clostridium difficile InfectionA Systematic Review and Meta-analysis – JAMA Internal Med
  8. Amanita phalloides Mushroom Poisonings — Northern California, December 2016 – MMWR June 2017
  9. Wild Mushrooms: An Exclusive Delicacy or Last Meal – ACG
  10. Treatment of NASH: What Helps Beyond Weight Loss? – ACG
  11. Small intestinal bacterial overgrowth and Celiac disease: A systematic review with pooled-data analysis – Neurogastro & Motility
Uncategorized

New Approaches to Controlling Health Care Costs

A Commentary in JAMA:Internal Medicine

David Lieberman and John Allen discuss what is probably going to happen to the colonoscopy payment system: – bundling: fixed fee for the anesthesia, pathological analysis, and repeated procedures due to poor bowel preparation.

Currently Centers for Medicare and Medicaid Services waive patient costs associated with anesthesia services (i.e. propofol for all). Some think it is not a great idea from a cost perspective. The authors point out that given focus on quality and patient satisfaction, anesthesia for all cases may not be a bad idea, especially if we enter the bundled payment system.

These are good points, but from a clinical perspective, the quality and patient satisfaction are not exactly two major parameters that enter my mind when it comes to what’s best for patient. Quality is slowly becoming a nebulous term which includes anything from access, cost, etc, and the contribution of clinical indication is rapidly declining in that formula.

And bundled payments may in the end not be so bad, as long as we all share in the costs of this, from primary care to the specialist.

One more thing -“…costly, cost-effective, and well accepted. In some areas, however, charges can vary more than 10-fold for the same services, from approximately $500 to more than $8000.” $8000 for a colonoscopy?  – Where? What kind of a colonoscopy does one get for that much money?