Mary W. Carter

"I don't think there's a single answer," said Mary Carter, a professor in West Virginia University's Department of Community Medicine who also works in the school's Center on Aging.

"It likely reflects a combination of the high rate of certain diseases prevalant in West Virginia along with certain types of industries and behaviors," she said.

West Virginia ranks high in obesity, cigarette smoking and physical inactivity and, correspondingly, in ailments like cardiovascular disease, diabetes and hypertension.

The state also has one of the highest percentages of residents 65 or older, and Carter said older people are at greater risk of disability through injury or illness.
...
Treatment of stroke survivors after they leave the hospital is too often ignored or downplayed, Carter said.

"Too many of our stroke patients are returned home from the hospital without any outpatient services," she said.

Mary Carter's research looks at older adults' month-to-month Medicare spending before, during and after treatment for an injury.
...
It's a pattern Mary Carter of the Department of Community Medicine at West Virginia University believes the health care industry could improve on.
...
If that person breaks a bone, Medicare spending spikes, Carter said. And when the cast is off and physical therapy is over, spending drops -- but never as low as before.

"We're back to just treating the heart disease and diabetes that existed prior to the injury," she said, "but we find now we're spending more to treat the same diseases that were there before."
...
To Carter, that suggests the baseline may not have to shift up -- maybe health care practitioners could do more to prevent injury or to help their patients recover more fully.

That idea squares with what she sees as a less proactive attitude in general in the medical world toward the health of older adults.

"People with congestive heart failure, they struggle with fatigue often," she suggested as an example.
...
If the research finds that certain patterns of treatment result in better outcomes, Carter said, it could both bring better quality of life for patients and save the system money.

"I don't think there's a single answer," said Mary Carter, a professor in West Virginia University's Department of Community Medicine who also works in the school's Center on Aging.

"It likely reflects a combination of the high rate of certain diseases prevalant in West Virginia along with certain types of industries and behaviors," she said.

West Virginia ranks high in obesity, cigarette smoking and physical inactivity and, correspondingly, in ailments like cardiovascular disease, diabetes and hypertension.

The state also has one of the highest percentages of residents 65 or older, and Carter said older people are at greater risk of disability through injury or illness.

"I don't think there's a single answer,'' said Mary Carter, a professor in West Virginia University's Department of Community Medicine who also works in the school's Center on Aging.

"It likely reflects a combination of the high rate of certain diseases prevalant in West Virginia along with certain types of industries and behaviors,'' she said.

West Virginia ranks high in obesity, cigarette smoking and physical inactivity and, correspondingly, in ailments like cardiovascular disease, diabetes and hypertension.

The state also has one of the highest percentages of residents 65 or older, and Carter said older people are at greater risk of disability through injury or illness.
...
"I don't think there's a single answer,'' said Mary Carter, a professor in West Virginia University's Department of Community Medicine who also works in the school's Center on Aging.

"It likely reflects a combination of the high rate of certain diseases prevalant in West Virginia along with certain types of industries and behaviors,'' she said.

West Virginia ranks high in obesity, cigarette smoking and physical inactivity and, correspondingly, in ailments like cardiovascular disease, diabetes and hypertension.

The state also has one of the highest percentages of residents 65 or older, and Carter said older people are at greater risk of disability through injury or illness.
...
Treatment of stroke survivors after they leave the hospital is too often ignored or downplayed, Carter said.

"I don't think there's a single answer,'' said Mary Carter, a professor in West Virginia University's Department of Community Medicine who also works in the school's Center on Aging.

"It likely reflects a combination of the high rate of certain diseases prevalent in West Virginia along with certain types of industries and behaviors,'' she said.

West Virginia ranks high in obesity, cigarette smoking and physical inactivity and, correspondingly, in ailments like cardiovascular disease, diabetes and hypertension.

The state also has one of the highest percentages of residents 65 or older, and Carter said older people are at greater risk of disability through injury or illness.
...
"I don't think there's a single answer,'' said Mary Carter, a professor in West Virginia University's Department of Community Medicine who also works in the school's Center on Aging.

"It likely reflects a combination of the high rate of certain diseases prevalent in West Virginia along with certain types of industries and behaviors,'' she said.

West Virginia ranks high in obesity, cigarette smoking and physical inactivity and, correspondingly, in ailments like cardiovascular disease, diabetes and hypertension.

The state also has one of the highest percentages of residents 65 or older, and Carter said older people are at greater risk of disability through injury or illness.
...
Treatment of stroke survivors after they leave the hospital is too often ignored or downplayed, Carter said.

Mary Carter's research looks at older adults' month-to-month Medicare spending before, during and after treatment for an injury.
...
It's a pattern Mary Carter of the Department of Community Medicine at West Virginia University believes the health care industry could improve on.
...
If that person breaks a bone, Medicare spending spikes, Carter said. And when the cast is off and physical therapy is over, spending drops -- but never as low as before.

"We're back to just treating the heart disease and diabetes that existed prior to the injury," she said, "but we find now we're spending more to treat the same diseases that were there before."

At the same time, some of what Carter has found in the data goes against common wisdom: The spending returns to its original rate of increase -- it doesn't assume a new, ever-rising rate.

That, she said, surprised her.

Medicare spending for older, uninjured adults naturally increases about 14 percent a year, she said.

Post-treatment for an injury, the spending baseline shifts up about 20 percent and then resumes its 14-percent-a-year rise.

To Carter, that suggests the baseline may not have to shift up -- maybe health care practitioners could do more to prevent injury or to help their patients recover more fully.

That idea squares with what she sees as a less proactive attitude in general in the medical world toward the health of older adults.

"People with congestive heart failure, they struggle with fatigue often," she suggested as an example.
...
If the research finds that certain patterns of treatment result in better outcomes, Carter said, it could both bring better quality of life for patients and save the system money.

At Wednesday's meeting, community medicine professor Mary Carter told faculty about a "culture of fear" at the center while biochemistry professor Michael Miller said students who criticized Mr. Garrison were being intimidated.

Mary W. Carter, PhD West Virginia University

Mary W. Carter

West Virginia University School of Medicine