Tips from gaining health

The Disease Management Care Blog recently received a curious email from the Patient Centered Primary Care Collaborative.  As readers may recall, this is the Washington DC-based coalition that advocates on behalf of the Patient Centered Medical Home(PCMH). 

The content of that rather defensive communication can be found here.

What provoked this? The premier internal medicine specialty journal, the Annals of Internal Medicine, published a comprehensive review of the peer-reviewed literature on the PCMH, and its authors skeptically concluded:

The PCMH holds promise for improving the experiences of patients and staff and potentially for improving care processes, but current evidence is insufficient to determine effects on clinical and most economic outcomes

Ouch. No "economic outcomes" means that there is no proof that the PCMH saves money.

Unlike the PCPCC membership, regular DMCB readers arent surprised.  For example, the DMCB pointed out months ago that the U.S. governments Agency for Healthcare Research and Quality ("AHRQ") had concluded the same thing.  Countless other DMCB posts on the medical home have pointed out that there were problems with the published PCMH literature (for example, here and here).

Thanks to a past Congressional Budget Office report, the DMCB feels the PCPCC pain. It also knows that a) finding statistically significant cost savings in health insurance data bases are notoriously difficult, b) successful medical home initiatives that are outside the academisphere are the least likely to be reported it in the peer-reviewed literature, c) "savings" isnt the only measure of patient value and d) journals like the Annals of Internal Medicine are being sidelined by innovators who are more astute judges of what works for their patients.

Whats changed for the medical home and the PCPCC after this unpleasant dust-up?  Ultimately nothing. Pairing nurses and physicians in team-based care, whether its done remote telephonic "disease management" style or in the clinic "medical home" style is ultimately a good idea with obvious face validity. The Annals problem is that we dont have pristine scientific methodologies that can identify, capture and measure the benefit.

The good news is that the science is getting better. Until it catches up, the population health and disease management service providers will remain in business and the medical home will continue to have a bright future.

Star fruit-Rich In Vitamins And Has Curative Properties

Recent studies are beginning to show that the star fruit has a number of medicinal properties, besides being rich in vitamins. After conducting several studies, researchers have found out that star fruit juice is capable of reducing blood pressure. When the juice was given to rats, their blood pressure dropped, followed by an increase, then a gradual drop.

It is thus possible that the star fruit, if consumed regularly, can help those suffering from high blood pressure. The fruits may also help to counter the effects of the many processed foods we eat which contribute to high blood pressure.

In another study, star fruit juice displayed antibacterial properties. Bacteria such as staphylococcus, which cause a number of ailments ranging from indigestion to skin problems, were found to be effectively controlled with the undiluted juice of the star fruit. The juice attacked the multiplying bacteria, reducing their number and thereby controlling their activity and hence any infection they could be causing.

This tasty fruit contains a lot of water-92 percent-and is also very rich in nutrients. Its vitamin C content is 25 mg for every 100 g edible portion, which is about 200 percent higher than that in fruits such as apples and pears.

The star fruit is also on of the richest sources of vitamin A. Every 100 g edible portion of the fruit has 155 mcg of vitamin A. It also contains some B-vitamins (thiamin, riboflavin), calcium and iron. Protein, fat and carbohydrate are present in small amounts.

According to some traditional beliefs, star fruit juice could be rubbed gently on the face to help maintain a clean, pimple-free complexion. And when rubbed on the hair, it is believed to be able to remove dirt and even dandruff. So consuming fruits such as the star fruit is really beneficial.