Many Colonoscopies for Older Adults May be Inappropriate (VIDEO)
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Many Colonoscopies for Older Adults May be Inappropriate
A study by Kristin M. Sheffield, Ph.D., and colleagues of the University of Texas Medical Branch, Galveston, that analyzed Medicare claims data for Texas and a sample from the United States suggests that many colonoscopies performed in older patients may be potentially inappropriate.
The study background highlights increasing evidence of overuse of the procedure and that some Medicare patients with negative findings at screening colonoscopy may be undergoing another screening too early.åÊ
The study results suggest that 23.4 percent of colonoscopies performed in Medicare beneficiaries 70 years and older in 2008-2009 in Texas and across the country were potentially inappropriate according to age-based screening recommendations or the results of a previous screening.
The rate of inappropriateness by age broke down as follows 9.9% for those 70 to 75; 38.8% for those 76 to 85, and 24.9% for those 86 years or older.
The colonoscopists with percentages significantly above the mean were more likely to be surgeons, graduates of US medical schools, medical school graduates before 1990, and higher-volume colonoscopists.
The likelihood of undergoing potentially inappropriate colonoscopy depends in part on where patients live and what physician they see.åÊ
ÛÏInappropriate use of colonoscopy involves unnecessary risk for older patients and consumes resources that could be used more effectively,Û the study concludes.
I think the most telling part is the variation by physician. Notice surgeons have higher rates. Why? They want potential surgeries. Graduates of US medical schools have higher rates. Why? It is the culture of medicine in the US to test, test, test. Older med school graduates have higher rates because newer thinking challenges all the testing. And of course those who make their living performing colonoscopies perform more. No surprise.
It is a personal choice for you. I had one at 50 and am due at 60. I will do it. I think the thinking is that as you get older perhaps there is less that you can do if you find something. In any case, question your physician, whether it is for your own care or that of a loved one. åÊ
Independent Transportation Network – Find One or Start One Near You (VIDEO)
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Planning to Retire Later? You’re Not Alone (VIDEO)
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Independent Transportation Network – Find One or Start One Near You
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| @ITN |
The Independent Transportation Networkå¨ (ITN), is the first and only national non-profit transportation system for America’s aging population.
ITNAmericaÛÜ‘s affiliates provide rides with door-through-door, arm-through-arm service to thousands of seniors nationwide. It allows older people to trade their own cars to pay for rides, and enable volunteer drivers to store transportation credits for their own future transportation needs.
ITNAmerica provides support to affiliates and is looking for new affiliate locations.åÊ
ITNAmerica‘s affiliate communities include Charleston, SC; Chicago, IL.; Portland, ME; Orlando and Sarasota, FL; Los Angeles, San Diego, and Monterey, CA.; Lexington, KY; Enfield, Middlesex, Middletown, West Hartford, Westport and Fairfield County, CT.; the Quad Cities of Iowa; Cincinnati, OH; Las Vegas, NV; Racine, WI; St. Charles, MO; Memphis, TN; Boston, MA; Detroit, MI.
ITNAmerica works with organizations and individuals to help develop dignified and sustainable transportation in communities across the country. The service may be used for any purpose, without restriction, in an ITNAmerica service area.åÊ
Independent Transportation Networkå¨ (ITN) volunteer drivers store transportation credits for their volunteer efforts. These credits may be used to plan for their own future transit needs or they may use these credits to help pay for rides for members of their family or for low income seniors.
Merchants such as super markets and shopping malls help to pay for rides. Community organizations such as churches, assisted living facilities, and health care providers may contract with ITN to provide transportation services for their members.åÊ
When older people have vehicles they can no longer drive, the ITN CarTrade㢠program helps them convert this depreciating capital asset into a fund to pay for their rides.åÊ
Adult children, family members and friends may give the gift of independence by purchasing an ITN gift certificate for the seniors they love.
Because ITN does not want to compete with public transportation for scarce tax payer dollars, it seeks to supplement public transportation by working directly with seniors, their families, and their communities to access private resources.
Interesting concept as transportation is such a hot issue in elder care. I hope there is a service near you. Perhaps you could be the catalyst in starting one.
