The WSJ Health Blog on Swine Flu

The Wall Street Journal is serving the public with insight and context on the Swine Flu threat

Live blogging from the CDC teleconference

Excerpt:  The WHO’s Keiji Fukuda is talking to reporters about the current swine flu situation. Here’s what he’s saying.

11:10: There have been 79 laboratory confirmed infections. Forty from U.S., 26 from Mexico, six from Canada, two from Spain, two from the U.K. and three from New Zealand. The WHO is reporting seven laboratory-confirmed deaths, all in Mexico. That’s a lower figure for deaths than others have reported.

11:15 It’s unclear whether this will turn into a pandemic. But countries should prepare for that possibility.

“A Century of Flu Pandemics”

Excerpt: Flu is a quickly mutating virus that infects birds, pigs and humans. So it’s only natural that, every so often, a new strain emerges from the animal world and starts passing from person to person.

These strains vary widely in the severity of disease they cause and in the ease with which they pass from person to person. Those variables aren’t yet clear in the case of swine influenza A (H1N1), the new strain of swine flu — and they may change over time, as the virus continues to mutate.

Looking back at flu outbreaks from the 20th century gives some sense of the range of possible outcomes.

There was the Spanish Flu of 1918, which this historical overview from the feds calls “the catastrophe against which all modern pandemics are measured.” Some 30% of the world’s inhabitants fell ill; there were an estimated 500,000 deaths in the U.S. alone.

ACEP Proxy System Coding

From Modern Healthcare:

HCA, Nashville, said using an emergency department coding procedure developed by the American College of Emergency Physicians boosted its operating earnings by $75 million to $100 million in the first quarter ended March 31. The company also said that its readmission rates compare favorably with those reported in a recent study in the New England Journal of Medicine.

HCA said that it earned $360 million, up from $170 million in 2008’s first quarter. Revenue increased 4.3% to $7.43 billion. Admissions declined 0.9% but equivalent admissions increased 1.9% when comparing the quarters on a same-facility basis in each case.

HCA began studying the use of the new coding procedure after the CMS said a so-called proxy system, such as the ACEP’s, would comply with Medicare regulations, said Milton Johnson, executive vice president and chief financial officer. The system, which HCA implemented fully by the end of 2008, greatly simplifies the coding procedure, Johnson said. Financial results of the coding system could vary in future quarters, Johnson added.

Jonathan Perlin, chief medical officer and senior vice president of quality, said that HCA’s Medicare readmission rates are much lower than the 19.6% of readmissions within 30 days of discharge reported in the journal study.