Hospitals

October 30, 2019

For patients, a glimpse into data on the quality and safety of surgery centers

They may be more appealing and convenient because they’re located in the neighborhood with better hours and more parking. They also may be less costly because they lack the high overheard of big hospitals. But those booming same-day surgery centers have patient safety issues of their own.

Their doctors and nurses may not be as well-trained as patients might find at big hospitals or academic medical centers, with 1 in 3 centers not having staff who were all board-certified, according to the Leapfrog Group, a consortium of big companies and other major health care users focused on patient concerns.

Leapfrog has issued — to its considerable credit — its first safety and quality study of the facilities, also finding that, “not all ambulatory surgery centers and hospital outpatient departments provide surgery consent materials before the day of surgery. Just 14% of ambulatory surgery centers provided the information one to three days before the surgery, while just 20.7% of hospital outpatient departments do so,” Modern Healthcare, an industry news source, reported.

October 25, 2019

Lawmakers order schools to give teens more time for California dreaming

by Patrick A. Malone

If millions of young folks in the nation’s largest state seem even sunnier than before, that may be because they are getting a wee bit more needed shut eye: California has become the first state in the nation to order public schools to roll back their start times, so middle school classes generally won’t start before 8 in the morning and high school teaching doesn’t start until after 8:30 a.m.

The rule — pushed by experts and resisted by parents juggling already hectic and conflicting family schedules — will be phased in over three years. It also will be accompanied by yet more research on how teens doze and how sleep can best benefit their rapidly growing minds and bodies.

California’s later start to teens’ schools got a boost from groups like the American Academy of Pediatrics, the California Medical Assn., and the California State Parent Teacher Assn. They cited a growing body of research, including by organizations like the RAND Corporation, tying more sleep from later start times to adolescents’ better school performance and health.

October 24, 2019

Seniors are getting urine over-tested and joints over-injected

by Patrick A. Malone

It’s the 21^st century, and excellent information is more available than ever due to communication and technology advances. But doctors and hospitals keep harming patients by testing and treating them in ways that are unsupported by rigorous medical evidence, and by carrying out safety recommendations in extreme ways.

Just consider:

Hospitals have become so obsessive about protecting seniors from falls while under their care that they’re all but lashing them to their beds, damaging their already shaky fitness, according to Melissa Bailer, a Kaiser Health News reporter whose work appeared in the Washington Post. She quotes experts as warning of an “epidemic of immobility” for older patients.

October 22, 2019

Caveat emptor: It’s not only an open season ‘for’ but also ‘on’ health coverage

by Patrick A. Malone

Americans in coming weeks will make important decisions on the national and personal level about how best to safeguard themselves and their loved ones with a crucial component of the U.S. health care system: their insurance coverage.

Though the exact timing of the open enrollment season varies by geography and plan, it’s that key time for millions who get their coverage via Medicare and may wish to make changes. These are important weeks, too, for many who obtain health insurance under the Affordable Care Act, aka Obamacare. Many workers are hearing a lot from their human resources folks about their employer-provided plans.

It’s clear from the political polling and the sometimes-dreary Democratic presidential debates that there’s huge interest and lots of devil in the details about Americans’ health insurance options.

October 18, 2019

Flu shot urgency rises with warnings from Down Under and vaping illnesses

by Patrick A. Malone

It’s an imperfect predictor, health officials concede. Still, a nasty season of infections Down Under has increased the urgency of their recommendations to the U.S. public to get the annual flu shot before Halloween and certainly before everyone sits down for Thanksgiving dinner.

Although concern already had been growing about bad months ahead in the United States for flu, an early and “fairly severe” season in Australia has increased officials’ worries, the New York Times reported.

That’s because the Aussies, while not a 100% reliable bellwether, showed the more populous States about flu severity as recently as last season, according to Donald G. McNeil Jr., who has reported on disease outbreaks in more than 60 countries for the New York Times. He wrote this:

October 15, 2019

In U.S. health care, experts assail $1 trillion-plus in waste, fraud and abuse

by Patrick A. Malone

Politicians almost by reflex decry the skyrocketing cost of U.S. health care by blaming much of it on waste, fraud, abuse. They, alas, really may be on to something, newly published research shows.

Health care experts, including a medical leader of health insurer Humana, “combed through 54 studies and reports published since 2012 that estimated the waste or savings from changes in practice and policy,” leading them to some jaw-dropping calculations about how well spent is the $3.5 trillion or so that Americans drop on health care, the New York Times reported.

Answer: Really badly. The researchers, in their published work, estimated that 20%-25% of American health care spending is wasteful. That turns into giant sums, fast, as the newspaper reported, including:

October 1, 2019

Health care plagued by cases of a persistent pathology — unmitigated gall

by Patrick A. Malone

There seems to be a never-ending outbreak of a certain kind of pathology in the United States. Big Pharma has it and spreads it around, a lot. So, too, do public health figures. Let’s call this scourge what it is — unmitigated gall.

The problem with this nasty condition is that it afflicts the rest of us. Just consider how stomach-churning these shenanigans can be:

Penalties for bogus prescribing of ‘little red pills’ on elderly dementia patients

September 29, 2019

Is Sanders’ plan to erase $81 billion in U.S. medical debt really all that crazy?

by Patrick A. Malone

Critics have attacked Sen. Bernie Sanders for his proposal to wipe out $81 billion in medical debt, including by changing rules around debt collection and bankruptcy. He also called for “replacing the giant credit reporting agencies with a ‘public credit registry’ that would ignore medical debt when calculating credit scores,” reported the New York Times.

Well, there he goes again, with interesting but hard to execute ideas, critics replied to Sanders’ medical debt idea, dissecting it to pieces.

But dig into some of the news articles and important realities flare up. Even his critics concede that medical debt has become a nightmare for too many Americans, contributing in unacceptable fashion to family stress and anxiety and, more importantly, adding to the nightmare of medical bankruptcy.

September 26, 2019

While it’s still warm and sunny, saunter in for that annual flu shot

by Patrick A. Malone

The weather may be sunny and temperate, the seasonal foliage a slowly changing delight to behold. But the savvy are prepping for sterner days ahead. It’s that time of year when doctors and public health officials urge us all to get that annual flu shot.

It’s never easy to forecast the severity with which influenza will sweep the country. But early indications — including a child’s death already attributed to the illness — suggest this may be a bad year for the bug.

Don’t downplay the harms of this all-too-common sickness: The federal Centers for Disease Control and Prevention estimates that there were as many as 43 million flu illnesses in this nation in the 2018-19 season, with more than 20 million cases serious enough to cause patients to seek medical care. The CDC says there were as many as 647,000 hospitalizations and up to 61,200 flu-related deaths. That toll included more than 100 children killed by flu.

September 18, 2019

There hospitals go again: UVA Health backpedals on draconian debt collection

by Patrick A. Malone

Is a public pillorying the only way to stop big hospitals from pursuing patients for medical debt with the zeal of demons from the underworld?

The University of Virginia Health System — an enterprise that racked up an $87 million operating profit on revenue of $1.7 billion in the fiscal year ending in June and that holds stocks, bonds and other investments worth about $1 billion — has become the latest institution to get a journalistic blaming and shaming for extreme debt collection practices that would make proud Inspector Javert in Les Miserables.

The independent, nonpartisan Kaiser Health News Service and the Washington Post deserve credit for their investigation into UVA avariciousness. As KHN reported of the state operation: