Congress Passes Mental Health Parity Bill

From Wall Street Journal Health Blog:

A long fight over putting the coverage of mental health on par with other health conditions is nearly over.

Both houses of Congress yesterday passed bills that would prohibit employers who offer mental health coverage from doing things like charging higher co-pays for mental health services than for other kinds of health care. That’s long been a common practice.

“You go in there with a broken arm, you have a $200 deductible and your insurance kicks in,” Rep. Patrick Kennedy told the Washington Post. “You have depression, schizophrenia, substance abuse, and you find out you have a $2,000 deductible, you’ve got limitations on your treatment and all kinds of co-pay.”

Scary Case

From White Coat Rants:

I have heard a lot of people say that anesthesia as a specialty is enticing because it is boring and “easy money” 98% of the time.

Then there’s that other 2% of the time. I don’t know if I could stand a boring job.

A 70-year old guy comes in with “tongue swelling.”

Flubbed handoffs of patients between doctors leads to errors, MGH survey finds

From White Coat Notes:

Patients routinely have responsibility for their care passed from one physician to another as doctors’ shifts end or as patients move from one department or hospital to another. When schedules of resident physicians were limited to 80 hours a week in 2003, the expected increase in handoffs — already a cause for concern because of the chance for miscommunication — attracted more attention.

Economy expected to curb healthcare philanthropy

From Modern Healthcare:

The nation’s worsening economy, already a stress on state budgets and investment portfolios, will likely undermine another source of healthcare revenue: philanthropy.

Giving across all sectors fell during all but two of six recessions since 1967, according to a survey of economic cycles and donations released by the Association for Healthcare Philanthropy. The current economic instability—stock market volatility, rising unemployment and inflation, falling home values and the credit crisis—suggests charities could see declining donations into next year, the report said.

Criteria Determine Out-of-Hospital Cardiac Arrest Patients Beyond Hope

From MedPage Today:

ANN ARBOR, Mich., Sept. 23 — Two sets of criteria may help determine whether out-of-hospital cardiac arrest patients will survive if they are sped to an emergency room, researchers here found.
Each contain criteria, called rules, for stopping resuscitation efforts and have high predictive value in identifying patients who are unlikely to survive to hospital discharge, Comilla Sasson, M.D., an emergency physician at the University of Michigan here, and colleagues reported in the Sept. 24 issue of the Journal of the American Medical Association.

In a retrospective analysis of cardiac arrest registry data, 100% of cases who met all five criteria of the more conservative of the two sets — to be used by providers of advanced life support — died before hospital discharge.

These conservative criteria are that the cardiac arrest is not witnessed by emergency medical services personnel or by a bystander, no automated external defibrillator or manual shock is applied out of the hospital, there is no return of spontaneous circulation out of the hospital, and cardiopulmonary resuscitation is not administered by a bystander.

Hospitals to Dirty-Handed Workers: We’ll Be Watching You

From the Wall Street Journal Health Blog:

When it comes to preventing infections in hospitals, one of the toughest challenges is getting health-care workers to wash their hands. Seems basic, but studies show compliance with hygiene rules is often less than 40%.

Now a company called Arrowsight is bringing to bear a Big Brotherish solution that has worked in food processing and manufacturing plants: a video surveillance system that measures adherence to hand-washing rules and provides hospitals with quick feedback on the laggards.

To pitch the system to hospitals, Arrowsight is tapping Suzanne Delbanco, 40, who most recently was CEO of the Leapfrog Group, the national coalition of large health-care purchasers that includes heavyweights like General Motors and Boeing. Leapfrog, created in 2000, aims to prod hospitals to provide safer, higher-quality care and reward them for a better job with payment incentives.

Though Arrowsight can’t yet say what it will charge for the watchdog service, Delbanco tells the Health Blog the company is working with a major academic medical center that she declined to name on a major pilot program. In an earlier pilot, launched in January of 2007, the company says its hospital video auditing service boosted hand-hygiene compliance to 90% from 38% in three months. The improvement was durable, remaining above 90% for twelve months running.

Survival Rates After Out-of-Hospital Cardiac Arrest Vary Widely

From MedPage Today:

SEATTLE, Sept. 23 — People who suffer cardiac arrest at home or on the street are much more likely to survive after emergency treatment in some cities than in others, researchers here said.

Survival rates after treated out-of-hospital cardiac arrest ranged from 3% in Alabama to 16.3% in the Seattle area, reported Graham Nichol, M.D., M.P.H., of the University of Washington, and colleagues in the Sept. 24 issue of the Journal of the American Medical Association.

Rates in the subset of patients with ventricular fibrillation varied even more widely, ranging from 7.7% in Alabama to 39.9% in Seattle.

The researchers estimated that 15,000 deaths could be prevented each year if every emergency treatment system could achieve the survival rates seen in Seattle.