Health Policy Dept. receives grant to improve access

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The Colorado Department of Health Care Policy and Finance — which took the biggest blow in the latest budget cuts — will receive a $42 million grant from the federal government.

Administered during the next five years, the grant will help health care organizations invest in infrastructure and technology to improve efficiency.

Access to medical services will be improved and will reduce the practice of cost-shifting to private insurance because of uncompensated care.

The department administers the Medicaid and Child Health Plan Plus programs, as well as a number of other programs for low-income families, the elderly and people with disabilities.

Older better for Warfarin

A study shows that the effectiveness of Warfarin — an anticoagulant medication — is most beneficial for the elderly, those who have had a stroke or those with multiple risk factors for stroke.

The findings will appear in the Annals of Internal Medicine.

Researchers followed 13,559 patients with atrial fibrillation in northern California from 1996 to 2003. The study was designed to determine how much the treatment’s potential benefits outweigh its risks.

Warfarin increases the risk of intercranial bleeding — bleeding in and around the brain, but it reduces the risk of ischemic stroke. Researchers attempted to balance the two factors in an attempt to guide doctors in making medical decisions about the drug.

While Warfarin therapy benefited most atrial fibrillation patients, the balance of benefits above risks was greatest in those with the highest risk of stroke — those with multiple risk factors, those with a history of stroke and the oldest patients. The benefits of treatment increased dramatically with age, with no clear benefit in the average patient younger than 65, but a reduction of more than two strokes per 100 patients in those 85 and older.

Atrial fibrillation affects more than 2.3 million people every year. It occurs when the upper chambers of the heart quiver instead of contracting smoothly — a disturbance that can create blood clots that can lead to stroke. The condition is dependent on age — 10 percent of people with atrial fibrillation are older than 80.

While researchers know that Warfarin is effective in preventing strokes, the treatment is difficult to control and can lead to hemorrhages. In fact, the drug is associated with the most emergency admissions for drug-related adverse reactions.

“This comparative effectiveness study gives us more information about which atrial fibrillation patients are most likely to benefit from carefully administered Warfarin therapy,” said Daniel Singer, study coauthor and a physician at the Massachusetts General Hospital Clinical Epidemiology Unit. “One of our distinctive findings is that stroke risk continues to increase in patients age 85 and older and that Warfarin provides substantial net protection for these elderly patients. A caution is that all these patients were presumably judged by their physicians to be reasonable candidates for Warfarin therapy, so these results do not automatically apply to all elderly atrial fibrillation patients.”

Projects get stimulus money

Gov. Bill Ritter has certified four water projects in El Paso County to be paid for through the American Recovery and Reinvestment Act.

The projects are part of 31 drinking and wastewater projects in 17 counties that will receive about $62 million and are estimated to create 600 jobs.

Manitou Springs is upgrading its water treatment facility and its water distribution facility. The cost of the project is $7 million. Manitou also will rehabilitate its sewer collection system. The cost is $1.9 million.

Monument will eliminate individual septic systems. The project will cost $418,000.

Widefield will upgrade its wastewater treatment facility at a cost of $1.7 million.

Amy Gillentine covers health care for the Colorado Springs Business Journal.