Tag: "hospital"

Hits and Misses

Woman Using Exercise MachineIs the motivation to exercise in your genes?

Does marijuana wreck your brain? Or was the study so much hype?

Readmissions: They may not be the hospital’s fault.

After years of failed attempts, researchers have finally generated stem cells from adults using the same cloning technique that produced Dolly the sheep in 1996.

About 16% of people who die in traffic crashes in the U.S. are bikers or pedestrians. Phoenix and Fresno are the worse cities for bikers. Detroit and Miami are the worse for pedestrians.

Good News for the Uninsured

Uninsured patients who seek trauma care at a Healthcare Corporation of America hospital will no longer be charged a special trauma fee, which sometimes added as much as $30,000 to their bills…

“Even so, waiving the trauma fees for uninsured HCA patients might have little impact. Hospitals generally collect only a portion of what they bill patients. And the amount collected from uninsured patients — compared to those covered by auto or health insurance policies — can be tiny.”

HCA told the newspaper that their hospitals collect $300 on average from uninsured patients. (More)

What Are We Getting for the $30 Billion We Are Spending On Electronic Health Records?

electronic-medical-recordIn 2009, the federal government budgeted $30 billion to incentivize doctors and hospitals to install electronic health records and use them “meaningfully”. Here are the results from Boston’s Brigham & Women’s Hospital — one of the leading academic medical centers in the country:

Of 858 physicians, 540 (63%) were “meaningful users”. Meaningful use was associated with marginally better quality for 2 measures, worse quality for 2 measures, and not associated with better or worse quality for 3 measures.

Meaningful use of electronic health records was correlated with better control of cholesterol in patients with diabetes and of blood pressure in hypertensive patients. The meaningful-use group provided worse treatment of asthma and depression than the non-MU group did.

HT: Ken Terry, Medscape.

Headlines I Wish I Hadn’t Seen

Canvbnadian study: Almost one-third of patients never fill the prescriptions for the medicines they are told to take.

Jails house 10 times more mentally ill than state hospitals.

Doctor billed Medicare for $21 million in 2012; investigated by the FBI; makes large donations to Democrats.

Washington Post fact checks TV ad Barrack Obama ran against John McCain and finds that all the scary predictions actually came true — it’s called ObamaCare.

Most of the 4,000 doctors who received at least $1 million from Medicare in 2012 billed mainly for giving patients injections, infusions and other drug treatments.

Hits and Misses

Is Paul Krugman a shameful floccinaucinihilipilificator?

PCPs are opting out: choosing less rigorous work for hospitals, concierge practice and retirement.

3D printing breakthrough: Surgeons replace entire skull.

At least three states with their own ObamaCare exchanges may let healthcare.gov take over.

Robert Wood Johnson Foundation ranks each county’s health using 13 factors – only two involve the health-care system.

Ontario, Canada’s largest province, moves to outlaw all gifts from drug-makers to doctors.

Why Bundled Payments May Not Reduce Costs

Hand Holding Cash…[T]he results of this analysis show that the case for bundled hospital payments for the privately insured is much weaker — post-acute care and other ancillary services account for a relatively small share of overall spending on hospitalization episodes, and they account for almost none of the variation in episode spending from one hospital to another.

Study. HT: Austin Frakt.

Surgical Checklists Don’t Save Lives

Atul Gawande has become famous for The Checklist Manifesto, which makes the case for delivering medical care like The Cheesecake Factory delivers cheesecake. However, David R. Urback and colleagues reported these results:

Implementation of surgical safety checklists in Ontario, Canada, was not associated with significant reductions in operative mortality or complications…

During 3-month periods before and after adoption of a surgical safety checklist, a total of 101 hospitals performed 109,341 and 106,370 procedures, respectively. The adjusted risk of death during a hospital stay or within 30 days after surgery was 0.71% (95% confidence interval [CI], 0.66 to 0.76) before implementation of a surgical checklist and 0.65% (95% CI, 0.60 to 0.70) afterward (odds ratio, 0.91; 95% CI, 0.80 to 1.03; P=0.13). The adjusted risk of surgical complications was 3.86% (95% CI, 3.76 to 3.96) before implementation and 3.82% (95% CI, 3.71 to 3.92) afterward (odds ratio, 0.97; 95% CI, 0.90 to 1.03; P=0.29).

Atul Gawande responds to the checklist study. So does Aaron Carroll.

Take The Money And Run? Some Hospitals, Physicians Dropping Out of Government Electronic Health Records Program

hospital money 300The 2009 HITECH Act authorized billions of taxpayers’ dollars be spent to pay hospitals and physicians “incentives” to adopt EHRs. The Congressional Budget Office estimates that the total tab will be $30 billion from 2011 through 2019. The Government Accountability Office has just reported on the results so far.

Not surprisingly, with so much money being spent, there was a lot of uptake: 45 percent of eligible hospitals had EHRs in 2011, versus 64 percent in 2012. For physicians and allied professionals, the share went up from 21 percent to 48 percent. However, the high net adoption rate disguises significant drop outs:

Specifically, within the 36 states that had completed their determinations of which providers would receive incentive payments for the 2012 Medicaid EHR program year, 61 percent of professionals and 36 percent of hospitals that participated in the Medicaid EHR program in 2011 did not continue in 2012. Sixteen percent of professionals and 10 percent of hospitals participating in the Medicare EHR program in 2011 did not continue to participate in 2012. (p. 23)

Headlines I Wish I Hadn’t Seen

18kqd35hi04oqjpgOne in five doctors may not be able to afford to continue vaccinating children on Medicaid and Children’s Health Insurance Program.

American Hospital Association wants Consumer Financial Protection Bureau to let hospitals use strong-arm debt-collection on patients with debts.

Florida Medicare Advantage Plan to pay for members’ fitness trackers (which means the plan seeks to enroll healthy, not chronically ill, seniors).

Huge privacy invasion: A management consultant uploaded England’s entire National Health Service patient database to Google servers outside the U.K.

Hits and Misses

zzzzzzzSurgery center of Oklahoma eliminates the $100 aspirin.

Curious factoid: About 20 percent of hospice patients are discharged alive.

Is there anything wrong with distinguishing between the “deserving” and the “undeserving” poor?

Nation’s third largest for-profit hospital chain expects only 15% of uninsured patients to get ObamaCare coverage.

Oliver Wyman actuaries estimate Medicare Advantage payment cut of $65-$145 per member per month in 2014 & 2015.

Creative destruction: Closed New Jersey hospitals reopen as for-profit medical complexes.