Articles Posted in Hospitals

cardmedicare-300x194Editor’s note: The blog will shift in ’23 to more episodic publication.

Just a reminder: 2023 will begin what could be consequential changes in aspects of older Americans, notably those age 65-plus and covered by Medicare.

As part of law of the Inflation Reduction Act passed by Democrats in the Congress and pushed by the Biden Administration, diabetics on original Medicare will see their cost for lifesaving insulin capped at $35-a-month under Part-D prescription drug plans. As the official Medicare site reports:

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In recent times, one of the issues most complained about by patients comes down to this: Why does my doctor zip through my office visit and fail to give me the attention I need and deserve?

To be sure, doctors these days struggle ever more with “efficiency” pushes in medicine by profit-obsessed business interests and private investors, combined with administrative demands — especially those tied to electronic health records.

These and other factors devour doctors’ frontline practice time. High-level policy makers, politicians, and regulators eventually may be forced to grapple with the rightful concern by regular folks that, as patients, they now confront the reality that a primary care doctor will spend on average 18 minutes with them in an office visit.

cash-150x150Editor’s note: The blog will shift in the days ahead to more episodic publishing.

Members of Congress raced at the year’s end to avoid the consequences of a brutal snowstorm battering huge swaths of the country. Before hitting the holiday exits, lawmakers approved a whopping $1.7 trillion bill to fund the federal government through the fiscal year and until next fall, spending giants sums on guns over butter.

Those who drill down on military budgets will be better positioned to determine the wisdom of the $858 billion appropriation by Congress for the Pentagon. The 4,000-plus pages that detail the measure’s allocations included $772 billion for domestic spending, including, of note for those focused on health care, items such as:

ascnesionlogo-300x102Big hospitals and hospital chains have wailed, with considerable justification, since the outbreak of the coronavirus pandemic about financial damages they have suffered due to costly shortages of desperately needed health staff. But the institutions fostered this staffing crisis, with profit-ravenous suits in executive suites boosting hospital bottom lines in flusher times by slashing one of the biggest expenses in the business — frontline health care workers.

To see this up close, let’s zoom in on the experiences of Ascension, one of the nation’s largest chains, to see how hospitals plunged themselves into an economic and medical care mire, the New York Times reported:

“Ascension …spent years reducing its staffing levels in an effort to improve profitability, even though the chain is a nonprofit organization with nearly $18 billion of cash reserves. Since the start of the pandemic, nurses have been leaving hospitals in droves. The exodus stems from many factors, with the hospital industry blaming Covidstaff burnout, and tight labor markets for acute shortages of staff. But a New York Times investigation has found that hospitals helped lay the groundwork for the labor crisis long before the arrival of the coronavirus. Looking to bolster their bottom lines, hospitals sought to wring more work out of fewer employees. When the pandemic swamped hospitals with critically ill patients, their lean staffing went from a financial strength to a glaring weakness.

Doctors working in hospital emergency departments face chaos, violence and high stress every day, and usually they get the diagnosis and treatment right. But, and it’s a big but, as often as one in seventeen ER visits ends with a misdiagnosis, which can have deadly consequences. Those medical misdiagnosis are newly estimated by Johns Hopkins medical school researchers as a significant peril for patients across the country.

Doctors in the too-often harried ER environs fail to correctly “identify serious medical conditions like stroke, sepsis and pneumonia,” leading to the deaths of as many as 250,000 patients each year, researchers at the Johns Hopkins University Evidence-based Practice Center found in their work for a federal health care oversight agency. The New York Times reported this of the work:

“The study, released [Dec. 15] by the Agency for Healthcare Research and Quality, estimates roughly 7.4 million people are inaccurately diagnosed of the 130 million annual visits to hospital emergency departments in the United States. Some 370,000 patients may suffer serious harm as a result. Researchers from Johns Hopkins University, under a contract with the agency, analyzed data from two decades’ worth of studies to quantify the rate of diagnostic errors in the emergency room and identify serious conditions where doctors are most likely to make a mistake. Many of the studies were based on incidents in European countries and Canada, leading some officials of U.S. medical organizations to criticize the researchers’ conclusions.

surgtools-150x150Seniors and their loved ones should take note of new and increasing data that researchers are developing about the risks undertaken by elderly patients who choose to undergo significant surgeries — procedures that make up a little less than half of costly operations performed in this country.

The numbers about invasive medical work can be mind-changing, especially for those with age-associated conditions, the independent, nonpartisan Kaiser Health News Service reported. As KHN’s “navigating aging” columnist Judith Graham wrote:

“Nearly 1 in 7 older adults die within a year of undergoing major surgery, according to an important new study that sheds much-needed light on the risks seniors face when having invasive procedures. Especially vulnerable are older patients with probable dementia (33% die within a year) and frailty (28%), as well as those having emergency surgeries (22%). Advanced age also amplifies risk: Patients who were 90 or older were six times as likely to die than those ages 65 to 69. The study in JAMA Surgery, published by researchers at Yale School of Medicine, addresses a notable gap in research: Though patients 65 and older undergo nearly 40% of all surgeries in the U.S., detailed national data about the outcomes of these procedures has been largely missing.”

fluill-150x150The coronavirus pandemic may not hold the iron grip it once held on newspaper front pages and lead stories on broadcast and online news outlets.

The infection, however, keeps inflicting major harms — taking a disproportionate and lethal toll now on older Americans, wreaking sustained havoc on the credibility of public health information and medical expertise, and debilitating as many as 15 million people with the perplexing problems of long Covid.

Hospitals across the country are warning the public that they are teetering on the brink of getting overwhelmed yet again as they battle a “tripledemic” — an unusually early wave of RSV cases, an early and virulent seasonal flu, and a rising and still challenging number of coronavirus illnesses.

tksgiving-300x177Millions of us will have much to give thanks for during the annual holiday, which, like several of its recent versions, again will be a time of health wariness and uncertainty, too.

The seasonal feast — which brings so many the joy of not only a grand meal but also the pleasure of gathering with friends, family, and other loved ones — will be more costly than any in recent memory due to economic inflation and supply chain problems, the Associated Press reported:

“Americans are bracing for a costly Thanksgiving this year, with double-digit percent increases in the price of turkey, potatoes, stuffing, canned pumpkin, and other staples. The U.S. government estimates food prices will be up 9.5% to 10.5% this year; historically, they’ve risen only 2% annually. Lower production and higher costs for labor, transportation and items are part of the reason; disease, rough weather and the war in Ukraine are also contributors.”

ACEP-300x98Almost three dozen leading groups representing a range of doctors, specialists, and other health workers have called on the Biden Administration to deal urgently with the long-running but increasing and dangerous practice of hospitals allowing their emergency care facilities to be overwhelmed because they also are parking patients waiting for rooms and treatment.

This “boarding” crisis, already at breaking points for many exhausted ER staffs, will worsen and imperil patients even more if the nation gets hit — as growing indicators suggest is occurring — with a “tripledemic,” a choking load of coronavirus, flu, and other respiratory infections serious enough to require hospitalization.

The American College of Emergency Physicians (38,000 members), has been joined by the American Medical Association, the American Nurses Association, American Academy of Emergency Medicine (8,000 members) and groups representing family doctors, allergists, anesthesiologists, radiologists, osteopaths, psychiatrists, and many others in a recent letter to the administration, reporting:

charitycarehospitalskff-300x209Already sick, injured, and debilitated by age and other circumstance, U.S. patient-consumers get battered with misleading information from shady firms about insurance coverage under the Medicare program and with too little word from hospitals about too spare charitable care that could help the beleaguered with bankrupting medical bills.

Democratic investigators for the U.S. Senate Finance Committee have ripped outfits hustling private Medicare plans to seniors, saying that companies have, among other sketchy practices uncovered, “posed as the Internal Revenue Service and other government agencies, misled customers about the size of their networks, and preyed on vulnerable people with dementia and cognitive impairment,” the New York Times reported.

The investigators said they have cataloged dubious behaviors by vendors in 14 states of Medicare Advantage programs. The newspaper earlier has reported those health plans have become a highly lucrative line of business for insurers. They overstate how sick their patients are to put a bigger bite on taxpayers’ financial support of health coverage for those 65 and older, with Advantage plans enrolling a huge chunk of seniors now.

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