City Health Information
November 2012 New York City Department of Health and Mental Hygiene Vol. 31(5):33-40
 

IN THIS ISSUE

 

Using Medical Resources Wisely
  • Unnecessary medical testing and intervention increase health care costs without improving patient care.

  • In April 2012, nine medical specialty boards issued evidence-based lists of tests and interventions that could be performed less often without compromising patient care.

  • Certain preventive medicine screenings and immunizations are underused and should be a routine part of patient care.

 

RECOMMENDATIONS FOR IMPROVING MEDICAL CARE

Since Take Care New York was launched in 2004, more New Yorkers have found a regular doctor, have quit smoking, and have been screened for colon cancer. The following recommendations are part of Take Care New York 2012, selected for both their public health significance and their amenability to evidence-based intervention and improvement (see Box).

 

BOX. QUALITY CARE PRIORITIES FROM THE NYC HEALTH DEPARTMENT

The following recommendations are part of Take Care New York 2012: a policy for a healthier city. City Health Information. 2009;28(suppl 5):1-8. The Health Department is currently preparing Take Care New York 2016, which will include a new set of health-related goals for New York City. See Resources for all publications cited below.

Behaviors

  • Weigh all patients and calculate their body mass index (BMI); monitor patients' BMI as you would any other vital sign (Take Care New York).
  • Recommend that all patients get regular physical activity and adopt a healthy diet low in sodium, sugars, and saturated and trans fats and high in fruits, vegetables, and whole grains (Take Care New York).
  • Encourage all women to plan their pregnancies and provide information on contraception (Quick Guide to Contraception).
  • Encourage exclusive breastfeeding in the first 6 months of life (City Health Information [CHI]: Breastfeeding).

Screening

  • Offer HIV testing as a routine part of medical care to all patients aged 13 to 64 years (CHI: HIV).
  • Screen patients 18 years and older for hypertension (CHI: Hypertension).
  • Screen for type 2 diabetes in adults with blood pressure greater than 135/80 (CHI: Diabetes).
  • Ask every patient about tobacco, alcohol, and drug use and offer evidence-based interventions if needed (CHI: Tobacco; Alcohol; Drug Users' Health).
  • Take a sexual history of all patients aged 12 years and older. Screen sexually active patients for sexually transmitted infections; encourage infected patients to notify their partners (CHI: Sexually Transmitted Infections).
  • Routinely screen patients for depression (CHI: Depression).
  • Screen for colon cancer and cervical cancer (CHI: Colorectal Cancer; US Preventive Services Task Force: Cervical Cancer).
  • Identify children at risk for developmental disorders during each well-child preventive care visit and make appropriate referrals (CHI: Early Intervention).

Immunizations

  • Make sure patients, especially children, in your practice receive all recommended immunizations on schedule, including an annual flu shot for those 6 months and older (ACIP: Immunization).

Disease Management

  • Discuss barriers to medication adherence openly with patients (CHI: Adherence).
  • Treat asthma aggressively with controller and rescue medications (CHI: Asthma).

PDF version of Box

 

Falls are a serious problem for older adults. Health care providers can help by reviewing and modifying medications, screening patients for falls risks, and talking to patients about falls prevention. For more information and tools, visit www.nyc.gov and search for "falls prevention."

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