FRIDAY, May 11 (HealthDay News) -- Regions of the United States with lots of hospital beds and a large population of lower-income patients tend to have higher hospital readmission rates than regions with fewer beds and a more affluent, healthier population, new research finds.

Factors related to supply and demand had more of an influence on readmission rates than the severity of the illness or the quality of care received by patients the first time they were admitted into the hospital, the study showed.

High hospital readmission rates, in which a patient is discharged but lands up back in the hospital soon after, is considered a key driver of soaring medical costs, and there have been many efforts over the past several years to try to keep people from returning to hospitals by improving follow-up care after discharge, with home health nurses, primary care doctors and other outpatient services.

Hospital readmission rates in the United States range from 10 percent to 32 percent, according to the study.

Based on their findings, researchers argued that new Medicare regulations that punish hospitals for high readmission rates may not actually improve care.

"We have to find ways to help hospitals and communities address this problem together, as opposed to putting the burden on hospitals alone," study author Dr. Karen Joynt, an instructor at Brigham and Women's Hospital, Harvard Medical School and the Harvard School of Public Health, said in a news release. "We need to think less about comparing hospitals to each other in terms of their performance and more about looking at improvement in hospitals and communities."

Researchers examined billing records from more than 3,000 hospitals across the United States from 2008 to 2009 involving more than 1 million elderly Medicare patients with heart failure. Patients' average age was 81. About 55 percent were female and 11 percent were black.

Communities with higher readmission rates were more likely to have a greater number of physicians and hospital beds. These supply-side factors accounted for 17 percent of the discrepancy in readmission rates.

The researchers also found the patients at these hospitals were likely to be poor, black and relatively sicker. Poverty and minority racial makeup accounted for 9 percent of the difference in readmission rates.

Meanwhile, hospital-performance quality accounted for 5 percent of the difference in readmission rates, and the severity of patients' illness accounted for 4 percent.

The U.S. Centers for Medicare and Medicaid Services plans to reduce payments to hospitals with higher-than-average 30-day readmission rates related to heart failure, heart attack and pneumonia next year, according to the authors. They argued this measure ignores the supply-side factors and societal influences driving readmission rates.

"To really address the readmissions issue, we need to think about this in terms of community and population health," Joynt noted. "Focusing on community-level factors -- such as the supply and mix of physicians and targeting efforts towards poor and minority communities -- may be more fruitful approaches to reducing readmissions. We need to think outside the walls of the hospital."

The study was expected to be presented Friday at the American Heart Association's Quality of Care and Outcomes Research meeting in Atlanta. Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. Department of Health and Human Services provides more information on hospital readmissions.

FRIDAY, May 11 (HealthDay News) -- Email vacations while on the job could benefit people's health, reducing stress levels and contributing to better focus, a new study suggests.

Researchers from the University of California, Irvine, and the U.S. Army found that a group of workers who were cut off from office email use for five days experienced more natural, variable heart rates and switched between computer windows only half as much.

Study co-author Gloria Mark, a professor of informatics at the university, said the findings could help boost productivity in offices that choose to implement these email vacations, either by controlling email login times, batching messages or through other strategies.

"We were surprised by the results, because they didn't have to turn out this way," Mark said. "It's possible that people might have been even more stressed not to have email, to feel like they were missing out on something, so we didn't expect that people would become significantly less stressed."

Mark and her colleagues presented the study this week at a meeting of the Association for Computing Machinery, in Austin, Texas. Research presented at scientific conferences is considered preliminary and has not been peer-reviewed.

Thirteen civilian employees at the Army's Natick Soldier Systems Center, near Boston, took part in a three-day baseline data-collection phase, including interviews about their existing multitasking and email usage, and a five-day no-email period. All participants, who were split between men and women, were information workers whose job titles included chemical engineer, psychologist, materials scientist, biologist, food technologist and research administrator.

Co-workers who continued reading emails switched screens twice as often -- an average of 37 times per hour compared with 18 for "vacationers" -- and were in a steady "high-alert" state, with more constant heart rates, while those removed from email had more natural, variable heart rates, according to the study. They reported feeling better able to do their jobs and stay on task, with fewer stressful and time-wasting interruptions.

"While the study focused on email . . . it really got at some important issues such as multitasking, focus and being present at what we do on a day-to-day basis," said David Ballard, head of the American Psychological Association's Psychologically Healthy Workplace Program. "It really highlights the importance of people not trying to do so many things at one time and being present at what they do."

Despite the small number of participants, the results were robust, researcher Mark said, and the only downside participants reported was feeling somewhat isolated -- though they were able to gather certain necessary information face to face from colleagues who did have email access.

Ballard said he has heard of some employers considering email blackout periods to benefit employees, but acknowledged that the concept "is a real challenge."

"The challenge here is that they would need to build some flexibility into the process," he said. "People like to work in different ways . . . not a one-size-fits-all approach."

"I think as we focus on flexibility in the workplace and flexible work arrangements that it's harder to implement an across-the-board solution like that," Ballard added. "We know from research that when employees have less control, it actually affects their performance as well. It could actually increase their stress level."

Mark said she'd like her future research to focus on how digital technology affects offline relationships, not just in the workplace.

"People are so consumed with technology, it's 24/7," she said. "I think the current younger generation interacts very differently than the older generation. I'd like to know the effect on interpersonal skills."

More information

Harvard Business School offers tips for mastering email overload  .

THURSDAY, April 26 (HealthDay News) -- Many American workers get fewer than six hours of sleep each night, putting themselves and their co-workers at risk for serious and sometimes deadly consequences, federal health officials said Thursday.

"There about 41 million workers who aren't getting the recommended amount of sleep," said Dr. Sara Luckhaupt, lead author of a new study from the division of surveillance, hazard evaluations and field studies at the National Institute for Occupational Safety and Health. The institute is part of the U.S. Centers for Disease Control and Prevention.

"Not surprisingly, workers who work the night shift are more likely to not get enough sleep," she said. Also, people who work more than one job or more than 40 hours a week are likely to get too little sleep, Luckhaupt said.

The National Sleep Foundation recommends that adults sleep seven to nine hours a night.

About 44 percent of night shift workers get too little sleep, compared to about 29 percent of people working the day shift. And certain industries take more of a toll on sleep than hours. Nearly 70 percent of those working night shifts in transportation and warehousing are sleep-deprived, the study said.

Working nights and sleeping during the day, in particular, disrupts the natural sleep cycle, called circadian rhythm, Luckhaupt said.

Workers who don't get enough sleep are more likely to get injured on the job and make mistakes that could injure them and their co-workers, according to the report.

Over time, insufficient sleep can also affect overall health, resulting in cardiovascular problems, obesity, diabetes and depression.

But there are way employers can help workers get enough sleep, Luckhaupt said, such as not starting shifts too early in the morning. If shifts rotate, it is better to go from an evening shift to a night shift than the other way around, she said.

Employers can also promote good sleep habits. These include going to sleep at the same time every day, having the bedroom quiet, dark and not too hot or too cold, and using the bed for sleep, not for reading or watching TV, Luckhaupt said.

For the report, published in the April 27 issue of the CDC's Morbidity and Mortality Weekly Report, researchers used data from the 2010 National Health Interview Survey to assess sleep habits of American workers.

Shelby Freedman Harris, director of the Behavioral Sleep Medicine Program and the Sleep-Wake Disorders Center at Montefiore Medical Center in New York City, said that "our society is a very sleep-deprived one."

The results are worrisome, he said, and include increased risk of heart attack, stroke, falls, car accidents, poor attention, depression, work absenteeism, irritability and weight gain.

"Despite these consequences, many people still don't find the time for adequate sleep, with many having trouble with insomnia and not seeking proper help," he added.

There are effective treatments to help with sleep issues arising from rotating shift work issues, but many people are unaware of them and many companies are not implementing them, Harris said.

For those working overnight shifts, strategically using bright light before and during work hours is helpful, along with dimming the lights at the end of the work period and wearing sunglasses on the drive home, he said.

For some workers, planning out a nap schedule is key. Others may require restructuring their sleep times at home, he added.

"I strongly encourage anyone who is struggling with adjusting to their shift to consult with a specialist. What is also important is making sure you have enough time between shifts to obtain a full night's sleep -- something many companies don't necessarily allow for," Harris said.

More information

For more information on sleep, visit the National Sleep Foundation  .

THURSDAY, May 3 (HealthDay News) -- New research suggests that a partial duplication of a gene played a significant role in a major advance in human brain evolution that occurred a few million years ago.

The SRGAP2 gene has been duplicated at least twice during human evolution, first about 3.5 million years ago and again about 2.5 million years ago. The second duplication produced only a partial copy of the gene, the study authors said.

This partial copy acts at exactly the same time and place as the original gene, allowing the partial copy to interact with and block the original gene's function, according to the findings published online May 3 in the journal Cell.

The partial copy of the SRGAP2 gene seems to have appeared at the same time that the fossil records show a transition from our extinct Australopithecus ancestors to the genus Homo, which led to and includes modern humans.

This point in human evolution is also when our ancestors' brains began to expand and major advances in intelligence likely occurred, according to Franck Polleux, an expert in brain development at Scripps Research Institute in La Jolla, Calif., and Evan Eichler, a genome scientist at the University of Washington in Seattle.

The researchers said that SRGAP2 and other human-specific gene duplicates may explain why humans are much more intelligent than other primates, despite few apparent differences in their genome sequences.

"We may have been looking at the wrong types of mutations to explain human and great ape differences," Eichler said in a journal news release. "These episodic and large duplication events could have allowed for radical -- potentially earth-shattering -- changes in brain development and brain function."

The findings also may provide clues to neurodevelopmental disorders, including autism, epilepsy and schizophrenia, the researchers said.

More information

The U.S. Institute of Neurological Disorders and Stroke has more about the brain.