CDC: Smoking deaths cost $92 billion


Early deaths caused by smoking cost the nation about $92 billion in lost productivity between 1997 and 2001, the Centers for Disease Control and Prevention reported Thursday.

Smoking reduces life expectancy an average of about 14 years by way of lung cancer, heart disease other illnesses, according to the CDC.

In the study, “lost productivity” meant lost wages. The CDC gave no overall estimate of the smoking-related health-care costs over the same five-year period, but estimated them at $75.5 billion in 1998 alone.

Altered Standards of Care in Mass Casualty Events

From the Agency for Healthcare Research and Quality (AHRQ), excerpted below. The webpage has a link to the reoprt and recommendations.

Mong the recommendations:
-Develop general and event-specific guidelines for allocating scarce health and medical resources
-Implement a process to address nonmedical (i.e., finance, communication) issues related to the delivery of health and medical care
-Develop a comprehensive strategy for risk communication with the public
-Develop practical tools such as searchable databases for verifying credentials of medical personnel on-site during a mass casualty event
-Develop a “Community-Based Planning Guide for Mass Casualty Care” to assist preparedness planners

The excerpt:

A mass casualty event could compromise the ability of health systems to deliver services meeting established standards of care. It is critical to plan for adjusting current heath and medical care standards to ensure that the care provided in a mass casualty event result in saving as many lives as possible.

To address the issue, an expert panel was convened by the Agency for Healthcare Research and Quality (AHRQ) and the Office of the Assistant Secretary for Public Health Emergency Preparedness, U.S. Department of Health and Human Services (HHS).

Move EMS from DOT to DHS?

Another article from JEMS, excerpted below:

A Homeland Security Policy Institute (HSPI) task force announced today that EMS would be more appropriately delegated to the U.S. Department of Homeland Security (DHS) than under its current administration by the U.S. Department of Transportation (DOT). The task force makes the assertion that “the time is ripe for EMS to move to a more suitable federal agency” because the modern responsibilities of EMS have outgrown its home with the DOT, a home that made sense when early EMS still focused on transporting MVC patients, according to the press release.

Gunshot-Wound Patient Slain in EMS Presence

From JEMS magazine, excerpted below:

Seventeen-year-old Billie Rutledge lay on a stretcher, bleeding from handgun wounds and yelling for help, while Detroit paramedics rushed to remove his clothing on Saturday, June 7, according to Free Press. However, before the paramedics could finish assessing him, the masked assailant returned to the scene, now armed with a shotgun, and fatally shot Rutledge in the head.

Rutledge, who had reportedly just finished serving a sentence for a misdemeanor conviction the day before his death, was on a walk with a friend when he was shot several times.

According to police reports, EMS arrived at approximately 3:30 a.m. and found Rutledge lying in a driveway, bleeding from small-caliber bullet wounds and screaming for help. Paramedics James Peyton and Toby Hanna put the patient on a stretcher and snipped off his clothing to locate the wounds.

As they carried the stretcher to an ambulance, the paramedics heard the sound of a shotgun racking and turned to find the assailant on scene again. Peyton and Hanna fled several yards before they heard two shots, the police report states. They were not injured and were on optional stress leave the following Monday.

ER Stats

From the National Center for Health Statistics “FASTATS” Emergency Department Visits page, (Data are for U.S. for 2003)

Number of visits: 113.9 million

Number of injury-related visits: 40.2 million

Number of illness-related visits: 74 million

Number of visits per 100 persons: 38.9

Most commonly diagnosed condition: acute respiratory infection

Percent of visits with patient seen in less than 15 minutes: 22.3

Average time spent in emergency department: 3.2 hours

Percent of visits resulting in hospital admission: 14

Percent of visits resulting in intensive care unit or coronary care unit admission: 1.3

Air Transport of Brain Injured Patients

Some good news for fans of air medical transport (we’ve been under fire lately), from an article on WNEP, based on research published in the Annals of Emergency Medicine:

A study finds patients with traumatic brain injuries who are transported by medical helicopters have higher chances of survival and better recoveries than ground-transported patients, according to a study published as an early online release by Annals of Emergency Medicine this week (The Impact of Aeromedical Response to Patients with Moderate-to-Severe Traumatic Brain Injury).

Helicopters are used in many systems to respond to major trauma victims because of their ability to transport patients rapidly and without delays that may hinder ground transportation. They also often have crews with advanced training and greater experience managing critically injured patients.

“Until now, there has been very little evidence to support whether frequently used air transport provides any more benefit to injured patients than ground transport,” said lead author Daniel P. Davis, MD, University of California San Diego Department of Emergency Medicine, and Mercy Air Medical Services in San Diego.

Unknown Illness Forces SLU Emergency Room To Divert Patients

From KSDK Newschannel 5’s website, excerpted below:

“Unknown Illness Forces SLU Emergency Room To Divert Patients”

An unknown illness in a patient caused doctors and health officials to shut off access to the emergency room at St. Louis University Hospital.

Around noon Thursday, a female was admitted with symptoms including a fever and a rash. Doctors initially suspected it might be Monkeypox, a rare disease that is less deadly than the similar Smallpox.

However, after faxing pictures of the woman’s symptoms to the Centers for Disease Control in Atlanta, the CDC gave SLU Hospital the go-ahead to re-open the emergency room.

Doctors now say it is highly unlikely that the woman has monkeypox, but they don’t yet know what she does have. The patient is being kept in isolation.

The emergency room started accepting patients again a few hours after patients were diverted.

Precription for Doctors: E-mail

An excellent article from USA Today, excerpted below:

“Prescription for doctors: E-mail”

In a 2002 survey by Harris Interactive, 90% of adults with Internet access indicated they want to communicate with their physicians via e-mail. But a survey last year by Manhattan Research, a marketing information and services firm, found that less than 20% of physicians communicate via e-mail.

The top reason doctors give for withholding their e-mail address is the fear that it will lead to “too much access” and they will be barraged with messages about “trivial matters,” according to a Journal of Family Practice article in 2001.

In other words, patients can’t be trusted not to abuse our doctors’ time. But if doctors finally moved into the high-tech age, they’d soon discover that many of their concerns about e-mail are misplaced.

Hospital Construction Kickbacks

Another interesting story from Modern Physician, excerpted below:

“Ill. construction exec pleads guilty in kickback scandal”

A Chicago construction company owner pleaded guilty yesterday to paying bribes to the former vice chairman of Illinois’ certificate-of-need board to direct hospital and medical school construction projects to his company.

In his plea, Kiferbaum confessed to paying Levine millions in bribes to steer building contracts to his company and to inflating the projects’ costs to cover those kickbacks. Kiferbaum and his successor company, Design+Build, agreed to pay $7 million in restitution by July 1. His sentencing hearing was postponed until after the cases against his co-defendants have been completed and the extent of his cooperation with U.S. District Judge John Grady in Chicago can be established.

EMTALA Violations

Excerpted from Modern Healthcare:

Four hospitals and health systems collectively paid $105,000 to settle alleged violations of the Emergency Medical Treatment and Active Labor Act with HHS’ inspector general, Modern Healthcare has learned.

Florida Hospital Heartland Medical Center, a 186-bed hospital located in Sebring, and owned by the Winter Park, Fla.-based Adventist Health System Sunbelt Health Care Corp., paid $20,000 for allegedly failing to provide appropriate medical screening and stabilization to a 21-year-old patient three times over a 12-day period. The patient later died of a rare and difficult-to-diagnose parasitic infection. The University of Alabama at Birmingham paid $40,000 to settle allegations that in September 2000 a member of the ER staff at its 226-bed UAB Medical West failed to provide a complete screening to a woman suffering from kidney infections and associated fevers and chills.