Articles Posted in Hospitals

walmartclinic-300x209Americans are showing with their feet and their money how they feel about doctors’ offices and  shiny hospitals, places they’re shunning more and more. They’re racing to neighborhood clinics and urgent care centers that seem to be popping up on every suburban street corner and shopping mall.

Before these facilities transform U.S. health care, would it be worth asking what this trend might mean, not just for profit-seeking retailers, drug store chains, and, yes, also hospitals and doctors who are shifting into new lines of business?

The New York Times found that:

mom-300x171Big Medicine can paper over its troubles with basic fairness by slapping fancy terms on them: take “health and gender disparities,” for instance. But doctors, hospitals, and the rest of us can’t make medical care more equitable, accessible, safe, and affordable without looking at inequities, square on.

That’s why the New York Times, Washington Post, and Associated Press deserve credit for recent deep digs into the struggles of women, poor women, and especially black women with modern medicine:

antidepressant-300x225Even as the nation enters an even scarier phase in its battle against the raging opioid abuse epidemic, new and sterner warnings are flying about antidepressants. The costs of these powerful drugs add up, as does the toll of depression and its care. Users say antidepressants are a nightmare to get off of. And medical experts cast growing doubt about whether their benefits outweigh their risks.

The New York Times deserves credit for detailing the worrisome plight of an estimated 15.5 million Americans who have been taking antidepressants — sold as brand drugs like Zoloft, Effexor, Paxil, Prozac, and Cymbalta — for at least five years. The rate of the psychiatric medications’ use “has almost doubled since 2010, and more than tripled since 2000,” the newspaper reported, adding that “nearly 25 million adults … have been on antidepressants for at least two years, a 60 percent increase since 2010.”

Users who try to wean themselves from the drugs find themselves, fast, in nasty situations with “dizziness, nausea, headache and paresthesia — electric-shock sensations in the brain that many people call brain zaps,” patients told the New York Times.

NORC-chart-300x179Although the United States remains the world’s most affluent nation, it also is a country where money plays a driving, negative role in its people’s well-being. Sudden financial losses  may shorten some Americans’ lives, while dismal finances may keep many others from seeking medical care.

So why are politicians still pushing to slash the nation’s social safety net, even as millions of individuals and families are voting with their wallets to protect their health?

Lethal ‘wealth shocks’

superbugs-300x118Hospitals may be providing us all with too many causes for high anxiety, with reports on increasing findings of “nightmare” bacteria stalking more health care facilities than had been known, more disclosures about how taxpayers may foot an even bigger bill to deal with a beleaguered public hospital in Washington, D.C.,  and a respected reform advocate’s detailing of just how traumatizing many hospital stays may be.

Let’s start with the new research by the federal Centers for Disease Control and Prevention, a study that tried to determine just how many cases there might already be of patients infected in hospitals, nursing homes, and other medical care facilities with so-called Superbugs, bacteria that resist treatment not only with most standard antibiotics but also drugs that are deemed therapies of last resort. These include three types of bacterial infections deemed especially urgent but difficult to control: Clostridium difficile (C. difficile), aka C-diff; carbapenem-resistant Enterobacteriaceae (CREs, as shown above); and Neisseria gonorrhoeae.

CDC officials weren’t sure how many of the Superbug cases — which leave doctors and hospitals little option but to provide only supportive care — they might detect by scrutinizing records from pathology labs nationwide.

coveredcalif-300x169Although Republicans have ripped at the health insurance offered under the Affordable Care Act, a less known but also important aspect of Obamacare may soon benefit Californians. This West Coast ACA-related move also may be worth watching by patients and medical safety advocates, as well as employers and insurers.

The Golden State, the San Francisco public radio station KQED reported, soon will tell hospitals that “time’s up” for them to improve their care, and, if they fail to hit new quality and safety targets that will be part of an impending three-year contract with Covered California, the ACA marketplace operator, they will get the boot from Obamacare coverage.

Because bluer-than-blue Democratic California has gone all-in in supporting and putting ACA coverages in place, the state’s Obamacare exchange is big (more than 1 million customers and 11 approved companies) and lucrative — so much so hospitals and insurers can’t ignore the quality demands. They’re neither extreme nor should they be surprising, because state officials emphasize they have consulted with key parties for several years now in the “Smart Care California” collaborative about the plans they intend to put in place.

Seroquel-25mg-300x195In a display of just how corruptive big money has gotten to be in modern medicine, Big Pharma keeps getting dubious doctors to write so-called off-label prescriptions for powerful anti-psychotic medications — no matter their proven harm to patients nor big settlements drug makers have been forced to pay.

The Washington Post deserves credit for its investigative dissection of AstraZeneca and its “blockbuster” product, Seroquel (generic name quetiapine). It’s a medication developed to treat severe cases of schizophrenia.

Instead, as has occurred with several other drugs of its kind, doctors — in response to major marketing and sales campaigns by AstraZeneca — have decided this wallop-packing drug can be given for uses for which there is less or little evidence. The Washington Post says doctors write abundant Seroquel scripts for patients with an “expansive array of ills, including insomnia, post-traumatic stress disorder and agitation in patients with dementia.”

Dumpster-300x251Although enthusiasts still wax on about  how technology will improve lives, patients may want to be wary about purported advances that may end up complicating and even compromising crucial parts of their medical care — including how their medical records are kept and how payers decide if they’re covered.

Let’s start with some kudos for dumpster-diving doctors in Canada who discovered flaws in hospitals’ disposal of supposedly confidential and legally protected patient health records. They went around unidentified facilities collecting from various bins a half ton of paper that doctors, nurses, and hospitals were ready to toss.

After examining the piles of paper, they found most private records had been properly handled. But thousands of documents also were not: They were improperly disposed of, and contained identifying or confidential patient treatment information, the researchers found. Though Canada’s patient privacy laws differ from those in the United States, they agree that patient health records must be guarded, and the researchers found violations of practice, policy, and potentially privacy laws.

medbankruptcy-300x253Illness and accidents batter and beggar Americans worse than many of us realize. New studies show it’s not just the cost of medical services but also long-term care and loss of jobs staggering the lives and finances of too many.

Margot Sanger-Katz, writing in the data-driven New York Times column, “The Upshot,” reported that hospitalization can wreak havoc on Americans older than 50, with many suffering a significant loss in income from which they never recover. This is true, even if they have some financial protection through health insurance. That coverage may soften the blow of medical costs. It doesn’t help them if they can’t return to work, must spend long periods out of work, or must reduce their work hours so they are part-time or less, finds a new study, published in the American Economic Review.

As she wrote:

maryland-flag-300x200Yes, Virginia (and Washington, D.C., and the rest of the U.S.): Ever-rising hospital costs can be constrained without the world coming to an end. Maryland’s four-year-old experiment — converting hospitals from a fee-for-service model to a global payment system with total revenues set at the outset of each year — is saving millions of dollars annually for patients, taxpayers, employers, and others who pay for medical services in the state.

The Baltimore Sun reported that Maryland’s Health Services Cost Review Commission and the Maryland Department of Health, found that the state’s unique test, already produced $586 million in hospital-related savings for Medicare in its first three years.

As the Sun said:

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