Fertility group supports employer coverage

A ruling from the U.S. Equal Employment Opportunity Commission (EEOC) in late April was hailed by the American Society for Reproductive Medicine in Birmingham, AL.

The EEOC ruled that a national publishing company’s ’exclusion of medically necessary treatments for infertility” violated parts of the Americans with Disabilities Act and Title VII of the Civil Rights Act.

’The EEOC ruling is an important first step in helping the more than 6.1 million American women and their partners, or about 10% of the reproductive-age population, who suffer from the disease of infertility,” says Larry Lipshultz, MD, president of the American Society for Reproduc tive Medicine. All patients have the right to seek and receive treatment for their medical problems, he adds.

New York focuses on advance directives

An independent health care quality evaluation organization is promoting patient use of advance directives and encouraging hospitals to provide more information about them in New York state.

IPRO, an independent, nonprofit organization in Lake Success, NY, began the study last year and will remeasure its progress later this year. IPRO abstracted information from medical records on two sample patient groups: those admitted with congestive heart failure (CHF) and those admitted for an elective total hip or knee replacement procedure.

Researchers hypothesized that patients would use an advance directive if their disease was more severe. A total of 58 hospitals are participating in either the CHF or the surgery portion of the study. CHF patients are on average four years older than the surgery patients. Participants are 41% male and 37% female. Also, CHF patients have a longer length of stay, averaging 7.6 days vs. 5.8 days for surgery patients. Key findings from the initial phase include:

• 63% of CHF patients, compared with 64% of surgery patients, received information from hospitals regarding their rights to an advance directive prior to or upon admission. This finding was not, however, related to the severity of diagnosis.

• About one-third of patients in either group had executed an advance directive prior to hospital admission. This finding also was not related to severity of diagnosis.

• Less than 15% of patients without an existing advance directive executed one during their hospitalization.

• Only one-third of preexisting advance directives were placed on the chart at any time during hospitalizations.

• Of the 43 patients who died during the study, 37% did not have an advance directive documented in their chart prior to death.