Reports Examine Physician Attitudes Toward Community Participation, Decline In Nursing Home Use

"Public Roles of U.S. Physicians: Community Participation, Political Involvement and Collective Advocacy," Journal of the American Medical Association: Many physicians believe that community participation, political involvement and collective advocacy are important in their roles as care providers, according to a JAMA study by Russell Gruen of the Harvard School of Public Health and the University of Melbourne and Eric Campbell and David Blumenthal of the Massachusetts General Hospital and Harvard Medical School. The report looked at data from the Institute on Medicine as a Profession's Survey on Medical Professionalism to determine physicians' attitudes toward participation in public roles, defined as "advocacy for and participation in improving the aspects of communities that affect the health of individuals." According to the study, more than 90% of survey respondents said community involvement is "important," and most rated it as "very important." In addition, more participants rated nutrition, immunization, substance use and road safety issues as "very important" than they did issues such as access to care, unemployment or illiteracy (Gruen et al., JAMA, 11/22).

"Nursing Home Use by 'Oldest Old' Sharply Declines," Lewin Group: Several factors have contributed to a decline in nursing home use, a study by Lewin Group Vice President Lisa Alecxih said. According to the study, 3.6% of adults older than age 65 used nursing homes in 2004, down from 4.2% in 1985. For people ages 85 and older, 13.9% used nursing homes in 2004, down from 21.1% in 1985. The report attributed the decline to several factors, including a decline in disability among the elderly and an increase in wealth, changes in Medicare nursing home payments, changes in the reasons people use nursing homes, alternatives to nursing homes, better long-term care insurance and efforts by states to reduce the number of Medicaid beneficiaries using nursing homes. In addition, the study highlights several federal and state initiatives that have contributed to a 10% decline in older nursing home residents since 1999 (Alecxih, "Nursing Home Use by 'Oldest Old' Sharply Declines," 11/21).


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