Latest news with #primarycare
Medscape
13 hours ago
- Health
- Medscape
Food Allergies Tied to Increased Mental Health Risk in Kids
TOPLINE: Food allergies in children were associated with elevated risks for eating disorders, anxiety, and depression. These mental health risks varied from those seen in children with other chronic conditions such as asthma, atopic dermatitis, and type 1 diabetes. METHODOLOGY: Researchers conducted a retrospective study including data from 1,153,984 children aged 0-18 years from UK primary care practices between 2000 and 2021 to assess the link between food allergies and mental health outcomes. The participants were categorized into those with food allergies (n = 23,263; median age, 5 years; 43% girls); without food allergies (n = 1,130,721; median age, 8 years; 48% girls); and with asthma (n = 136,453; median age, 8 years; 43% girls), type 1 diabetes (n = 4835; median age, 11 years; 45% girls), or atopic dermatitis (n = 207,575; median age, 5 years; 51% girls) with no history of food allergies. All participants were followed up for at least 1 year and up to 20 years to assess the development of specified mental health conditions. TAKEAWAY: Children with food allergies had significantly higher risks of being diagnosed with eating disorders (adjusted hazard ratio [aHR], 1.85; 95% CI, 1.42-2.41), anxiety (aHR, 1.35; 95% CI, 1.25-1.45), and depression (aHR, 1.24; 95% CI, 1.11-1.39) than children without food allergies. Children with food allergies had a significantly lower risk for depression than their peers with asthma (aHR, 0.77; 95% CI, 0.68-0.87) and those with type 1 diabetes (aHR, 0.64; 95% CI, 0.54-0.76). The risk for anxiety was significantly lower among children with food allergies than among those with asthma (aHR, 0.86; 95% CI, 0.79-0.91). IN PRACTICE: 'In light of these results, we recommend a holistic approach to FA [food allergy] management that integrates mental health screening and support into routine care,' the authors wrote. 'This could involve regular psychological assessments, educational programs about potential mental health risks for patients and families, and closer collaboration between allergists and mental health professionals,' they added. SOURCE: Natalie Flaks‑Manov, with KI Research Institute, Kfar Malal, Israel, was the lead author of the study, which was published online on July 16 in the European Journal of Pediatrics. LIMITATIONS: The study was potentially limited by its retrospective design and reliance on routine electronic health record data, lacking confirmation of mental health diagnoses by specialists or use of standardized tools. Additionally, data on both the severity of various conditions and family history of mental illness were missing. DISCLOSURES: The authors reported having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
a day ago
- Health
- Medscape
Direct Primary Care Providers Get a Major Policy Win
Clinicians who provide 'direct primary care' (DPC) and their patients are gaining a major windfall from the recently passed federal budget reconciliation legislation. Thanks to the 'Big Beautiful Budget Bill,' patients will be able to dip into their health savings accounts (HSAs) to pay for DPC services, which are designed to offer relief from assembly-line medicine. DPC providers are enthusiastic about the change, which will go into effect on January 1. But a critic warns that DPC, which emphasizes smaller patient loads and longer appointments, squeezes other forms of primary care and hurts the poor. Here's a closer look at what the new policy means. What Is DPC? DPC is a healthcare delivery model that allows physicians to contract directly with patients or employers for a fixed monthly membership fee. The DPC membership fees typically cover unlimited routine primary care services and lab work plus preventive care, basic procedures, and vaccinations — but not prescription drugs or specialty services. There are no copays. This is in contrast to traditional employer health plans that involve multiple stakeholders who 'take a piece of the pie,' such as third-party administrators, pharmacy benefit managers, and insurance brokers, said healthcare attorney Barbara Zabawa, JD, of Kansas City, Kansas, in an interview. Why Do People Like It? DPC providers say the model allows them to escape the bureaucratic constraints of traditional healthcare systems. The providers also tout patient perks such as same- or next-day appointments, shorter wait times, and more personalized care. 'Generally, DPC physicians have a panel of between 600 and 800 patients. In typical FFS [fee for service] settings, the patient panels tend to range from between 2000 and 2500 per family physician,' the American Academy of Family Physicians (AAFP) says. Critics, however, say DPC hurts primary care access overall. In a 2018 JAMA commentary, two physicians wrote that 'DPC presents physicians with an incentive structure built on accepting healthier patients with limited healthcare needs and a willingness to pay a retainer fee. Practices directly benefit when targeting healthier patients and declining coverage to the ill.' In addition, they wrote, 'DPC practices once held accountable through value-based payment systems have no obligation to report or measure quality metrics.' Is DPC the Same as Concierge Care? The terms are often used interchangeably, said healthcare attorney Joanna Eimer of Glenview, Illinois, in an interview although she thinks of them as distinct. DPC is a kind of concierge care, she said, 'but there are a lot of concierge services that have grown and become bigger, different kinds of models that include other services as well besides direct primary care.' There are other differences. 'Concierge care' is also often used as shorthand for highly expensive, luxury health services that are marketed to ultra-wealthy people and may cost tens of thousands a year. And as the 2018 JAMA commentary noted, in contrast to concierge care, 'the DPC model traditionally does not 'double dip' by billing insurers.' What About Patients on Medicare? According to AAFP, 'primary care practices can continue to see Medicare beneficiaries, as long as the practice's retainer fee does not cover services already covered under Medicare.' What Does the New Legislation Do? It allows people with high-deductible health plans to use HSA funds to pay for qualifying DPC membership fees up to a limit of $150 a month for one person or $300 for a couple or family. The fees will no longer be considered ineligible health insurance payments. DPC arrangements may not cover prescription drugs (other than vaccinations), laboratory services 'not typically administered in an ambulatory primary care setting,' and procedures requiring general anesthesia are excluded. According to KFF , the change is expected to cost the federal government about $2.8 billion through 2034. 'This is a big, big win, a big boon for people trying to use their HSAs and be a part of these DDC arrangements who weren't allowed to take advantage of these savings before,' Eimer said. 'It gives them more flexibility.' How Big Is DPC? According to the DPC Coalition, more than 2300 DPC practices in 48 states and Washington, DC, serve more than 300,000 patients. The organization says that 'as of 2025, 34 states have enacted laws and regulations generally defining DPC as a medical service outside of state insurance regulations as well as offering varying levels of consumer protection.' Who's Behind All This? A bipartisan group of House representatives have pushed for changes in the HSA policy regarding DPC, including physician Kim Schrier, MD (D-WA). AAFP is a prominent supporter of DPC. Will This Change Encourage More DPC Use? It's unclear what the change in policy will mean for DPC, whose growth has skyrocketed in recent years and is expected to continue expanding at a rapid clip. However, plenty of Americans — one estimate puts the number at nearly half of private-sector workers — are enrolled in high-deductible health plans. For now, at least, the new regulations should reduce confusion among patients and clinicians. Amy Mechley, MD, a DPC provider in Cincinnati, said the existing law regarding DPC and HSAs could be interpreted in different ways, and she couldn't give her patients firm guidance about what to do. Some got frustrated. 'This is absolute move in the right direction so that they're more in charge of how they're going to finance their healthcare,' she said in an interview. Are There Direct Care Practices in Specialty Medicine? Yes. The legislation regarding HSAs doesn't affect them. Is Everyone Pleased? No. Stephanie Woolhandler, MD, MPH, a primary care physician and researcher with Hunter College in New York City, worried about the broader implications for healthcare equity. On one hand, she said, 'it's pretty easy to understand why patients who have the money would choose to buy their way out of the dysfunctional system. It's also easy to understand why doctors who are so frustrated with collecting insurance payments would want to walk away.' However, DPC 'actually worsens the situation for patients who don't have the money to pay extra since it tends to take doctors out of the primary care pool and has them taking care of a smaller number of patients.' She added that HSAs 'don't work very well for poor people because they often don't have any money to put in, or their employer doesn't put much in,' she said. But they're great for 'wealthy people in higher-tax brackets who are in very good health.' In the big picture, she said, 'by abandoning people who can't pay that extra fee for direct primary care, you're actually making the whole financing system worse, not better. We need to change the system, but this is going in the wrong direction.'
Yahoo
4 days ago
- Health
- Yahoo
GP honoured for 35 years of helping the homeless
A GP from Leicester who has worked to improve the health of homeless people since 1990 has been given an honorary doctorate. Dr Nigel Hewett accepted an honorary Doctorate of Science award from the University of Leicester at a ceremony at De Montfort Hall on Thursday. In 2000, he set up the Leicester Homeless Primary Healthcare Service - which became Inclusion Healthcare - to provide services for homeless and other marginalised people. He was awarded an OBE in 2006 for services to homeless people and in 2009 he launched University College London Hospital's Pathway homelessness team. A lifelong Leicester resident, Dr Hewett said he was "delighted and humbled" by the honour. "Leicester has an outstanding primary health care service for people experiencing homelessness and asylum seekers," he said. "We should be proud to be national leaders in this field and this humbling award is a recognition of multidisciplinary team work over the decades." In 2010, he was a founder member of the Faculty for Homeless and Inclusion Health and became medical director of Pathway – a charity formed to support the faculty and improve the healthcare of homeless people and other excluded groups. Dr Hewett told the BBC: "I've always felt drawn to people on the margins of society and people who have had the most to gain from health care. "There's a thing called the inverse care law which suggests that the more you need medical care the harder it is to get it and homeless people are at the extreme end of that spectrum of deprivation." Homeless 'feel invisible' Dr Hewett said he saw one of his former patients while visiting the University of Sheffield. The patient had problems with heroin, but with the help of methadone went on a long-term detox and is now signing on for a PhD after completing a degree in criminology. "There's always a way back," Dr Hewett said. "You have to hang on to the wins in this work, because for most people they have age of death in the early 40s and it's often a very sad story." He added that homeless people often "talk of feeling invisible" and said "the rest of us can help, I think, by just making eye contact and saying hello". Follow BBC Leicester on Facebook, on X, or on Instagram. Send your story ideas to eastmidsnews@ or via WhatsApp on 0808 100 2210. More on this story Kasabian frontman receives honorary degree Council to keep new flats for homeless families Council to buy student flats to house homeless Related internet links University of Leicester Solve the daily Crossword
Yahoo
4 days ago
- Health
- Yahoo
GP honoured for 35 years of helping the homeless
A GP from Leicester who has worked to improve the health of homeless people since 1990 has been given an honorary doctorate. Dr Nigel Hewett accepted an honorary Doctorate of Science award from the University of Leicester at a ceremony at De Montfort Hall on Thursday. In 2000, he set up the Leicester Homeless Primary Healthcare Service - which became Inclusion Healthcare - to provide services for homeless and other marginalised people. He was awarded an OBE in 2006 for services to homeless people and in 2009 he launched University College London Hospital's Pathway homelessness team. A lifelong Leicester resident, Dr Hewett said he was "delighted and humbled" by the honour. "Leicester has an outstanding primary health care service for people experiencing homelessness and asylum seekers," he said. "We should be proud to be national leaders in this field and this humbling award is a recognition of multidisciplinary team work over the decades." In 2010, he was a founder member of the Faculty for Homeless and Inclusion Health and became medical director of Pathway – a charity formed to support the faculty and improve the healthcare of homeless people and other excluded groups. Dr Hewett told the BBC: "I've always felt drawn to people on the margins of society and people who have had the most to gain from health care. "There's a thing called the inverse care law which suggests that the more you need medical care the harder it is to get it and homeless people are at the extreme end of that spectrum of deprivation." Homeless 'feel invisible' Dr Hewett said he saw one of his former patients while visiting the University of Sheffield. The patient had problems with heroin, but with the help of methadone went on a long-term detox and is now signing on for a PhD after completing a degree in criminology. "There's always a way back," Dr Hewett said. "You have to hang on to the wins in this work, because for most people they have age of death in the early 40s and it's often a very sad story." He added that homeless people often "talk of feeling invisible" and said "the rest of us can help, I think, by just making eye contact and saying hello". Follow BBC Leicester on Facebook, on X, or on Instagram. Send your story ideas to eastmidsnews@ or via WhatsApp on 0808 100 2210. More on this story Kasabian frontman receives honorary degree Council to keep new flats for homeless families Council to buy student flats to house homeless Related internet links University of Leicester
CBC
4 days ago
- Health
- CBC
Toronto-based researchers want to hear from you about your experiences in health care
The OurCare survey last asked over 9,000 Canadians in 2022 about the state of primary care in the country, but didn't get much input from Newfoundland and Labrador. This year, the team wants to change that. Primary care researcher Dr. Tara Kiran spoke about the survey and its impacts with the CBC's Carolyn Stokes.
