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TUESDAY, Aug. 26 (HealthDay News) -- France is doing it. Britain, the Netherlands and Norway are on their way.

And hospitals elsewhere should be doing it, too, namely moving toward all single rooms in newly built hospitals, argue the authors of a paper in the Aug. 27 issue of the Journal of the American Medical Association.

"[Previous studies] have shown that it does reduce infections, there is some evidence that it may reduce medication errors, the physician can talk to the patient in private, and the family can be there," said Jane Bolin, an associate professor of health policy and management at Texas A&M Health Science Center School of Rural Public Health in College Station. "I think hospitals are going that way."

According to background information in the article, multi-bed wards have been the norm in hospitals, with semi-private and private rooms reserved for those who could pay.

Now, single, double and four-bed rooms are the norm, though single rooms were signaled as the best way to deliver patient care almost a century ago.

Among the numerous benefits of private rooms, according to the authors, from Sunnybrook Health Sciences Centre and the University of Toronto in Canada:

• They reduce hospital-acquired infections, especially important in the age of methicillin-resistant Staphylococcus aureus and SARS. "Most of the cases of the SARS outbreak in Toronto came out of a hospital, which could have been avoided if they didn't have multiple patients in a room," Bolin pointed out. Private rooms also have private bathrooms, again helping to curb infection.
• Patients who have changing needs won't need to be transferred to other rooms, possibly resulting in harm to the patient. Even now, baby-delivery suites can quickly be transformed into semi-surgical rooms when needed, Bolin said.
• Patients can get access to beds more quickly. Now, for instance, two empty beds in a male-only room would go to waste if females were waiting for beds.
• Private rooms mean you don't have to discuss your sensitive medical matters in front of strangers.
• Families and friends will find it easier to visit (many single rooms already have parent or spouse beds).
• Private rooms are calmer and have lower noise levels, which helps keep blood pressure, heart rate and respiratory rate in check, along with improved pain control and sleep quality.

A focus on single rooms would increase construction costs, with one study finding that the cost for building a new ward with only single-patient rooms would be $182 to $400 per patient, versus $122 to $500 per patient for a ward with double rooms.

But many of those costs are capital costs and would be recouped relatively quickly.

"Many people consider an expensive hotel room to be $300 to $500 per night, whereas the average cost per night in a hospital is $400 to $2,000," Bolin said. "About $40,000 in overall construction costs could be recouped, and it's not that much, considering the cost of equipment."

More information

Visit the American Hospital Association   for more on issues affecting hospitals.

MONDAY, Aug. 25 (HealthDay News) -- Bloodletting is often dismissed as a primitive form of medicine, in which early doctors attempted to rid the body of bad humors by draining the life-sustaining fluid.

But there's at least one disease left where bloodletting is still the preferred means of treatment.

Hemochromatosis is an inherited disease in which the body becomes overloaded with iron. When that occurs, the iron builds up in organs and tissues, causing slow damage from within that prompts a multitude of symptoms and illnesses.

"Until people get sick, they don't usually know it's there," said Gerald Koenig, director of the Iron Disorders Institute. "We think it's the most underdiagnosed disease in the country."

There are about one million people in the United States with a genetic predisposition for contracting hemochromatosis, Koenig said. "About 150,000 can expect to get sick, some very much so," he said.

Hereditary hemochromatosis is one of the most common genetic disorders in the United States, most often affecting Caucasians of northern European descent, although other ethnic groups are also at risk, according to the U.S. National Institutes of Health.

Iron is an important micronutrient for the human body and is found in many foods, mainly in red meat and iron-fortified breads and cereals. In the body, iron becomes part of hemoglobin, a molecule in the blood that transports oxygen from the lungs to all body tissues.

"Most people maintain just the right amount of iron in their bodies," Koenig said. "It varies by a gram or two between people."

But hemochromatosis causes the body to absorb too much iron from food, with the metal collecting over a period of years in such organs as the heart, liver and pancreas. Depending on how each person's body deals with the excess iron, the symptoms of hemochromatosis can vary widely.

And this makes it very hard to diagnose the true disorder accurately, said Eugene Weinberg, professor emeritus of biology and microbiology and immunology at the Indiana University School of Medicine, in Indianapolis.

"It takes a while for even an astute physician to detect," Weinberg said. "It's interesting how different the presentation is from patient to patient. It's such a jumble, and that's what puts a burden on the general practitioner."

Blood tests, combined with a thorough family medical history, usually are used to narrow the diagnosis down to hemochromatosis.

But, iron levels aren't usually tested during normal blood screening, Weinberg said. Patients must request the testing, although some experts are working to make it part of medical checkup screenings.

"We're tying to get an iron test put in there, so we can get at iron loading," he said.

Cirrhosis of the liver is one of the most common diseases resulting from hemochromatosis, Koenig said. "Ninety percent of the iron absorbed will go to the liver," he said, adding that the disorder can also cause enlarged liver, cancer of the liver or liver failure.

Joint pain and severe arthritis in the fingers are other very common symptoms, Weinberg said. "If a person comes in and can't open their fist, that's referred to as 'iron fist,' " he said.

Undiagnosed and untreated, hemochromatosis increases the risk for diseases and conditions such as diabetes, irregular heart beat or heart attack, arthritis, cirrhosis of the liver or liver cancer, depression, impotence, infertility, hypothyroidism, and some cancers, according to the NIH.

The NIH lists other common symptoms and diseases related to hemochromatosis, including:

• Fatigue or lack of energy.
• Loss of sex drive or impotence.
• Early menopause.
• Abnormal pigmentation of the skin, making it look gray or bronze.
• Thyroid deficiency.
• Damage to the adrenal glands.

Some people might not suffer any problems at all. Weinberg said there's a 100-year-old retired faculty member he knows who has a very high iron load but no ill effects from it.

"Here's a person who was able to tuck away the iron without it causing destruction of the organs," Weinberg said. "And yet there are other people who can't handle it."

The best means of treating hemochromatosis is phlebotomy, Koenig said -- bloodletting, one of the most ancient, and mostly discredited, forms of medical treatment. But, in this case, the draining of blood forces the body to process its excess iron.

"When you take blood out of the body, iron stored in body tissue is used to make new blood," Koenig said.

Some hemochromatosis sufferers can give blood as frequently as twice a week to stay healthy, very often to blood banks. "Most people only are allowed to give blood once every seven weeks," Koenig said.

Oral medications that would help the body better rid itself of iron are being tested, but, for the time being, bloodletting is the most simple and pain-free way to help sufferers lead normal lives, he said.

More information

To learn more about hemochromatosis, visit the Iron Disorders Institute  .

MONDAY, Aug. 25 (HealthDay News) -- Uninsured Americans will spend $30 billion out of pocket for health care, and receive $56 billion in uncompensated care in 2008, new research shows.

Uncompensated care is defined as health care that is received but not paid for by the uninsured or a health insurer.

In a report appearing in Monday's online edition of Health Affairs, Jack Hadley, of George Mason University, and John Holahan, Teresa Coughlin and Dawn Miller, of the Urban Institute, analyzed data on medical spending in people who are insured versus those who are uninsured.

They found that people uninsured for any part of 2008 receive about half as much care as those who are fully insured. A person who is uninsured all year will average $1,686 in medical costs, while someone who is privately insured will average $3,915.

And, the researchers pointed out, the uninsured pay an average of $583 (35 percent) of their costs, while the insured pay an average of $681 (17 percent).

"The uninsured receive a lot less care than the insured, and they pay a greater percentage of it out of pocket. Contrary to popular myth, they are not all free riders," study author Hadley, a senior health services researcher at George Mason, said in a news release from the journal.

The researchers also estimated that the federal government pays for about three-quarters ($43 billion) of the uncompensated care bill, including roughly $18 billion in special payments to hospitals by Medicare and Medicaid; $15 billion in tax appropriations and indigent care programs by state and local governments; and almost $10 billion in spending by the Veterans Health Administration, the Indian Health Service, community health centers and similar direct-care programs.

Finally, the researchers estimated that if all people uninsured for all or part of 2008 were to gain health-care coverage, the uninsured would increase their medical spending by $122.6 billion -- an amount equal to about 5 percent of current health spending.

"From society's perspective, covering the uninsured is still a good investment. Failure to act in the near term will only make it more expensive to cover the uninsured in the future, while adding to the amount of lost productivity from not insuring all Americans," Hadley said.

More information

The Agency for Healthcare Research and Quality has more about health insurance.

FRIDAY, Aug. 22 (HealthDay News) -- Using lasers to spot troubled teeth before cavities form, researchers hope to turn the dentist's drill into a relic of the 20th century.

The technology, called "Raman spectroscopy" (RS), is not brand new. In fact, scientists in other fields have long been using it to distinguish between various chemicals, based on their unique molecular fingerprints.

But this is the first time RS has been used to identify teeth in the very earliest stages of decay, the British research team said.

"The technique we are working with can tell the difference between [healthy] enamel and decaying enamel, and so in the future, if this technology is further developed, a dentist could identify early decay using it," explained study co-author Frances Downey, a graduate student with the Biomaterials, Biomimetics & Biophotonics Research Group operating out of the Dental Institute of King's College London.

Results of what Downey and her colleagues refer to as a "preliminary" effort were reported at the Microscience 2008 conference held recently in London.

The new approach to cavity prevention might be available for practical use five years down the road, Downey said. For the moment, work has been conducted solely with already extracted teeth, rather than with actual patients.

Researchers took advantage of the fact that cavities develop when the acids produced by microorganisms found in dental plaque begin to demineralise tooth enamel and produce distinct chemical changes.

By focusing RS optical fibers on individual teeth, the authors were able to track the unique light patterns that emanate from chemical compositions on either healthy or decaying enamel.

Theoretically, such a process could quickly spot tooth decay at a much earlier stage than the current screening standard, which is based on visual exams and X-rays.

The result of such early detection might be cavity prevention, not repair, the researchers said. In essence, sites of decay could be rematerialized with medicinal mouthwashes and fluoride varnishes, preventing the development of full-blown cavities and eliminating the need for dental drilling.

Study supervisor Dr. Frederic Festy said that larger studies involving patients are in the planning stages.

"However, that is not to say dentist drills would become obsolete," said Downey. She and her team noted that, in its current form, the screening procedure would be both expensive and time-consuming. "I think there will always be those of us who like our sweets a bit too much, and visit the dentist too infrequently, to keep them in business," she said.

But Charlie Brown, national counsel for Consumers for Dental Choice, based in Washington, D.C., hailed the innovation as an "excellent development."

"Anything that means that there might be fewer filling materials used in the mouth is a tremendously positive development," Brown said. "I salute any technology that will scan the mouth and prevent cavities before they occur, so we can try to have the least intervention in the mouth as possible."

More information

There's more on dental cavities at the American Dental Association  .