Public Health Officials Struggle To Identify Sepsis Before It Becomes Deadly

From the Kaiser Health Network:

The federal Centers For Disease Control and Prevention Tuesday released a study about sepsis as part of an effort to draw attention to the importance of prevention and early detection of the disease.

“Early treatment is vital,” said Dr. Anthony Fiore, chief of the epidemiology research and innovations branch at the CDC’s Division of Healthcare Quality Promotion. “It’s an emergency that you need to deal with, like heart attack and stroke.”

When sepsis advances to septic shock, characterized by severely low blood pressure, each hour of delay in administering antibiotics decreases the odds of survival by an average 7.6 percent, one study found.

How Emergency Providers Can Adopt Alternative Payment Models

From RevCycleIntelligence:

With many value-based care initiatives aiming to reduce costly emergency room visits, some emergency departments are finding it increasingly difficult to engage with alternative payment models, according to a report in the American Journal of Managed Care.

Researchers stated that alternative payment models should address key challenges of delivering care in the emergency department. While emergency care providers treat patients during sudden and unexpected crises, this can make it hard for departments to predict demand for care and align care delivery with value-based goals. Many emergency departments also lack the infrastructure and coordination strategies to track patient costs and outcomes longitudinally.

Dialysis Patients Use Emergency Rooms At Six Times Rate of General Population

From Medical Research:

We found that the characteristics that predict higher emergency department utilization in the ESRD population are similar to the general U.S. population (e.g. more comorbidities, tobacco or alcohol use, and socioeconomic factors like public vs., private insurance), however, the absolute rates of emergency department utilization are about six times higher than the general U.S. population. We found that within the first year of starting dialysis, 55% of patients have an emergency department visit, and about half of those patients are admitted to the hospital. Potentially preventable factors associated with higher ED utilization included catheter or graft (vs. a fistula) for dialysis access and not being under the care of a nephrologist visit prior to starting dialysis.

Indianapolis system to open 4 emergency micro-hospitals

From IndyStar:

St. Vincent is planning to open four free-standing emergency hospitals in the Indianapolis area to bridge the gap between the urgent care center and an acute-care emergency department.

The four facilities — planned for Noblesville, Castleton, Avon and Plainfield — will offer round-the-clock emergency care with the option of overnight stays for patients who need it. Each hospital will have seven outpatient beds and eight in-patient beds.

Also known as micro-hospitals, the emergency hospitals are part of St. Vincent’s strategy to provide care to patients closer to their homes. Earlier this year, St. Vincent entered into an agreement with Kroger’s Little Clinic to provide care at 10 in-store clinics.

Two senators urge scrutiny of EpiPen price boost

From USA Today:

Two U.S. senators are raising concerns about massive price increases on a drug used under emergency conditions for food allergy reactions to see if they are justified.

Sen. Chuck Grassley, R-Iowa, has written the manufacturer, Mylan, asking for the reasons behind the price
boosts for EpiPen, an epinephine auto-injector used to treat allergy reactions that has seen its price rise from $57 in 2007 to about $500 today. Sen. Amy Klobuchar, D-Minn., wants the Federal Trade Commission to take a look.

“I am concerned that the substantial price increase could limit access to a much-needed medication,” Grassley wrote in the letter to Mylan CEO Heather Bresch.

Rural health needs improvement

From Agri-View:

The County Health Rankings & Roadmaps program helps communities identify and implement solutions that make it easier for people to be healthy in their neighborhoods, schools and workplaces. Ranking the health of nearly every county in the nation, the County Health Rankings illustrate what is known regarding what is keeping people healthy or making people sick. The roadmaps show what can be done to create healthier places to live, learn, work and play. The Robert Wood Johnson Foundation collaborates with the University of Wisconsin Population Health Institute to bring this program to communities across the nation.

Each year, the County Health Rankings bring actionable data to counties across the country, serving as a call to action to improve local health. The 2016 Rankings include an in-depth examination of the differences in health between rural and urban counties, with some revealing findings:

As the number of freestanding ERs grows, so does scrutiny

From the AP:

There doesn’t appear to be market incentive for many of the stand-alone centers to open in rural areas that are home to poorer populations. At least 45 hospitals in less populated parts of the U.S. have closed since 2010, and a quarter of those were in Texas, according to the Texas Organization of Rural and Community Hospitals.

So far, the freestanding ERs have not filled the void left by those closings.

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