Failing Sight Tied to Fall Risk

HOT TOPIC

Three Eye Diseases Linked to Falls and Fractures in Older Adults

According to a recent article in JAMA Ophthalmology, three leading causes of age-related vision loss—cataracts, age-related macular degeneration, and glaucoma—have been found to increase risks of patient falls and fractures. The study authors found that patients with any one of these disease processes had a 25% to 38% higher risk of falls or fractures when compared with patients of a similarly aged population without age-related vision loss.

Although the paper's findings don’t prove that these ocular diseases are the cause of the falls and fractures, the higher risk of falls compared with control patients is statistically significant.

Notably, this study seems to agree with a previous survey conducted by the CDC of adults 65 years of age and older, which found that 47% of those with severe vision loss had reported a fall within the past year compared with 28% of those without severe vision loss. (Read more here.)

My Two Cents

As an eye doctor, this study will motivate me to educate my patients with any one of these three age-related eye diseases on their seemingly higher risk of falls and fractures. It may seem obvious that if a patient can’t see, their risk for bodily harm rises; however, this is likely something that our patients have never been explicitly told. So, the next time a patient asks how their disease may affect their everyday life, I’ll be sure to state that studies have found an increased risk of falling.

OUTSIDE THE LANE

Private Equity-Owned Hospitals = Riskier Care for Patients?

A large study published in JAMA found that health care became more hazardous and less effective for patients at hospitals purchased by private equity firms.

The study looked at the rates of 10 serious adverse events associated with medical care at 51 hospitals before and after they were purchased by private equity firms. The study authors compared the results with the rates of the same complications at 259 hospitals not owned by private equity firms. The outcomes of almost 5 million hospitalizations were analyzed, which were available through Medicare claims data.

The adverse events analyzed mainly consisted of “never events” because they’re entirely preventable medical errors that should never occur during routine medical care. Some examples include leaving a foreign object in the body after surgery, incorrectly matching a patient’s blood type, falls/fractures, and infections at surgical sites.

So, what did the study authors find? The rates of hospital-acquired complications increased by 25% at hospitals after private equity firms purchased them. According to the study’s author, Zirui Song, MD, PhD, there was a 27% increase in falls, a 38% increase in central line infections, and a doubling of the rates of surgical site infections. (Read more here.)

My Two Cents

Woah. This is horrifying, to say the least. I’ve stumbled across various studies that have suggested a potential lowering of care quality in private equity-owned clinics and hospitals, but this extremely comprehensive study seems to have blown the lid off and supported that hypothesis.

CAN YOU RELATE

The holiday season has passed, and many are happy to return to our regular routines. But before I close the door on 2023, I would like to share what I did for my team, because it was the biggest hit in all my years of practice. Now, although my team doesn’t work directly for me (ie, I don’t sign their paychecks), they are an extension of me and the care I provide. As such, I do everything I can to make them feel appreciated and encourage their loyalty. Because of this, my team has stayed together and flourished longer than any other in our large practice. I think these little gifts of appreciation and acts of service have made us effective coworkers and friends.

Usually, each year, I like to get each team member various little items that make me think of them. For example, if someone likes sushi, I’ll get them a sushi gift card and some sushi-themed kitchen utensils, t-shirts, etc. Unfortunately, this year, the time I typically use to ponder and shop for my team was taken up by other priorities. And so, on the day before our holiday break, I grabbed my team, and took them out for a quick lunch. Afterwards, we headed over to a sporting goods store, where I had them pick out the sneaker of their choice.

Now, to many of you reading this, a new pair of shoes might not be a huge deal, but for some people it is, and it was so worth seeing the smiles that this gesture brought to the faces of those who I care deeply about. Besides, when they’re running all day helping my patients, it’s safe to say that a good pair of shoes might help them run just a little faster. 😉