Download September 2004 Strategic Planning – Cost Utilization Kidslink

September 2004
Strategic Planning – Cost Utilization
Kidslink : Depression in Children
Over-the-Counter Drug Restrictions
Ask Us! Should I get a flu shot?
Testicular Cancer
Important Links and Numbers
We would appreciate your feedback. Please send any comments to us at:
[email protected]
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Strategic Planning – Cost Utilization
When you shop for a car or an appliance, how important is it for you to get the best price
along with the best service? Well, if you’re a wise consumer, we’re sure that it’s very
important.
At NIHP we also feel that making sure that you get the best price for the best service in
healthcare is important. Over the last few months we’ve been talking to you about some
of the directives in our strategic plan. One of the goals is to study cost utilization and
make sure that our customers are getting the most for their money.
We will start studying cost utilization by looking at the data from NIHP claims. We want
to see statistically what we are paying for and how much we’re paying for it. Then we
want to determine what national averages are, so we can make sure that our healthcare
costs are in the right ballpark. Finally, we will compare different providers so we can
recommend the best value for your money.
For example, if NIHP regularly refers our members to hospitals outside of FHN for heart
surgery, we want to be able to tell you not only the success rate and customer
satisfaction rate of those hospitals, but also the cost differential. If two hospitals have
equally high customer satisfaction and success rates but their costs are thousands of
dollars apart, we will be able to let you know. Then you’ll be able to make a wise
consumer healthcare choice.
We hope to begin this data gathering in the beginning of 2005, so we can make sure that
your healthcare dollars are used in the most reasonable manner.
If you have any questions, please feel free to contact us at:
[email protected]
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Kidslink : Depression in Children
Childhood should be the happiest time in your children’s lives, at least it seems that way
from an adult perspective. That’s why it is often surprising to learn that a high number of
children and adolescents experience serious, major depression at rates similar to their
adult counterparts. It many cases, adolescent depression leads to adult depression, so
recognizing and understanding the problems at the early stages is vital for your child’s
good mental health.
What do children have to be depressed about? Plenty, say experts. Children who are
constantly criticized, who battle behavioral problems such as Attention Deficit Disorder,
who live in a family with domestic violence, or who are being bullied or teased tend to
have higher incidents of depression. In addition, kids worry about much the same things
as adults: money, their future, and certainly their appearance. School worries and exams
can lead children to create illnesses in order to miss school, since they are often as
anxious about school as adults are about work.
The following symptoms of depression are more common in children and adolescents:
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Frequent nonspecific complaints such as headaches, muscle aches, stomach aches
or fatigue
Increased irritability, anger, or hostility
Being bored
Reckless behavior
Outbursts of shouting, complaining, unexplained irritability, or crying
Poor school performance
Fear of death
Alcohol or substance abuse
Source: Depression in Children and Adolescents, National Institute of Public Health,
If you suspect that your child or teenager may be depressed, don’t be afraid to talk about
it with him or her along with your healthcare professionals. Talking about depression
does not increase the risk for your child, and may be the first step in the healing process.
Jane Hager Paradowski, PsyD is a Clinical Psychologist for FHN. Her office is
located at the FHN Family Counseling Center, 1840 S. West Avenue, Freeport, IL
(815) 599-7890.
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Over-the-Counter Drug Restrictions
Drug abuse. You’ve heard the term, you know the symptoms, and most importantly you
know the likely sources. Or do you? Most people are unaware that the greatest risk of
drug abuse might be for those items already located in their own medicine cabinet – and
available without a prescription.
Americans buy about 5 billion over-the-counter (OTC) drugs each year to treat
headaches, heartburn, coughs, colds, and other routine health problems. Because they
can be purchased so easily, consumers are often fooled into thinking they are all
harmless. While they are generally safe when taken using the directions on the label,
most are strong medications that can be damaging when taken improperly.
Unfortunately many people, including a high number of youth, have started “pharming” –
the practice of getting high on supersize doses of OTC cough medicines, decongestants,
antihistamines, or even antidiarrheal remedies. The U.S. Office of National Drug Control
Policy in Washington, D.C. has reported seeing cases of children as young as grade five
involved in pharming.
Popular for abusers is dextromethorphan (DXM), a cough suppressant found in many OTC
cold remedies, including Robitussin, Coricidin HBP Cough & Cold, and Contact. The active
ingredient in decongestants is pseudoephedrine, which is also the key ingredient used to
produce the addictive illegal drug methamphetamine. In high doses, these drugs act like
PCP or heroin – inducing visions and hallucinations.
Many states have drafted laws that classify certain medicines as controlled substances
and limit where and how they can be bought and sold. Effective January 1, 2005, Illinois
law will prevent individuals from buying more than two packages of medicine containing
ephedrine or pseudoephedrine during a single purchase, and will restrict how medicines
containing these two ingredients must be displayed in retail stores; i.e. they may be
located behind the counter or in locked cases. A few pharmacies have already begun
restricting access and sales.
As with all suspicions of substance abuse, these steps can help you protect those you
love:
 Talk with the person – Let him or her know that you understand the dangers of
the products being used.
 Know your stuff – Educate yourself about the dangers of popular drugs at
Partnership for a Drug-Free America: http://www.drugfreeamerica.org
 Watch for warning signs – New friends, altered sleep patterns, extreme mood
swings, or loss of interest in favorite activities may be signs.
 Check the trash – Look for empty packages of cold and cough medications.
Bernard Lischwe, LCSW, CMADC, is a counselor for FHN. His office is located at
FHN Family Counseling Center, 1840 S. West Avenue, Freeport, IL (815) 5997890.
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(Please submit your “Ask Us” questions to [email protected] or
Ask Us, Northern Illinois Health Plan, 1006 W. Stephenson, Freeport, IL 61032 –
questions will remain anonymous.)
Ask Us! Should I get a flu shot?
Note: Always check with your healthcare provider before making a final decision on
whether you or members of your family should receive a flu shot.
Who should be vaccinated?
The Centers for Disease Control and Prevention suggest that anyone in the following four
categories should consider having the annual flu shot:
 Persons at increased risks for complications – Includes people over age 65;
residents of nursing homes or of elder care facilities; persons with chronic
disorders of the pulmonary or cardiovascular systems; persons who have had
medical hospitalization or treatment in the previous year for chronic metabolic
diseases, renal dysfunction, hemoglobinopathies, or immunosuppression; children
and adolescents (aged 6 months–18 years) who are receiving long-term aspirin
therapy; and women who will be pregnant during the influenza season. New this
year is the recommendation that ALL children aged 6 to 23 months get a
flu shot.
 Persons aged 50–64 years - Persons aged 50–64 years without high-risk
conditions receive a benefit in the form of decreased rates of influenza illness,
decreased work absenteeism, and decreased need for medical visits and
medication, including antibiotics.
 Persons who can transmit influenza to those at high risk – Includes
physicians, nurses and other healthcare workers; nursing home or elder care
employees; household contacts to persons in high-risk groups.
 Travelers and students – Includes persons planning to travel (both in and
outside of the U.S.); students who may be housed in close proximity to other
people.
When should I be vaccinated?
Beginning each September, the flu shot is offered to people at high risk as part of their
routine office visit or as a result of hospitalization. The best time to get vaccinated is from
October through November, as flu activity in the United States generally peaks between
late December and early March. Vaccinations are offered and are still effective even after
November and throughout the flu season, as long as vaccine is available.
Robert D. Geller, MD is board certified in Internal Medicine and Infectious
Disease. His office is located at the FHN Family Healthcare Center, 1036 W.
Stephenson St., Freeport, IL (815) 599-7740.
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Testicular Cancer
Testicular cancer occurs most often in men between the ages of 15 and 39, and is the
most common form of cancer for males between the ages of 20 and 34. In the United
States, about 7,500 men are diagnosed with this form of cancer each year. Luckily, this is
also one of the most curable forms, as studies have shown that the cure rate exceeds
90% when found early.
Experts recommend that individuals practice a regular self-examination in order to detect
any abnormalities. The best time to perform the self-exam is during or after a bath or
shower, when the skin of the scrotum is relaxed. To perform a testicular self-exam:
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Hold the penis out of the way and examine each testicle separately.
Hold the testicle between the thumbs and fingers with both hands and roll it
gently between the fingers.
Look and feel for any hard lumps or nodules (smooth rounded masses) or any
change in the size, shape, or consistency of the testes.
Before becoming needlessly alarmed, individuals should note that normal testicles will
contain a small bump on the upper and middle outer side of the testis, along with blood
vessels, tissues and sperm-conducting tubes.
Symptoms for men of all ages may include general pain or discomfort in the testicles,
along with lumps, swelling or enlargement. Lower back or groin aches are often a
symptom as well.
At the physician’s office, a patient can expect a complete medical exam that will check for
risk factors and symptoms. The provider will examine the testicles to detect any sign of
swelling, tenderness and to determine the size and location of any mass. Additional
screening, if needed, may include blood tests, an ultrasound test (to determine if a mass
is solid- or fluid-filled), and a biopsy (an examination of cells or tissues).
Much progress has been made in treating testicular cancer. Not only have surgical
methods been refined, but chemotherapy and radiation are also used to treat different
types of cancer. Your healthcare provider will assist you in making the best selection to
return you to an active lifestyle.
One final note, embarrassment is not a justification for avoiding a physical examination
that could improve the quality of your health. Only a physician can make the final
diagnosis, so if something feels irregular, go see the doctor.
Patrick Fernandes, MD is board certified in Radiation Oncology. His office is
located at the Leonard C. Ferguson Cancer Center, 1163 W. Stephenson St.,
Freeport, IL (815) 599-7000.
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Important Links and Numbers
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Upcoming FHN Events – http://www.fhn.org/events.cfm
Provider Directory – http://www.nihp.com/providers.cfm
FHN Same Day Care – (815) 599-7877, or toll-free, 1-866-686-4575
FHN Convenient Care – (815) 599-6100
Note: Check your specific insurance plan for coverage levels on all items mentioned
in this newsletter.